Economic burden of psoriatic patients in Japan: Analysis from a single outpatient clinic

Abstract

Topical and systemic agents have dramatically improved the treatment efficacy of psoriasis. Few reports, however, exist describing the economic burden in Japanese psoriatic patients. The aim of the study was to evaluate the total costs as well as cost versus efficacy of topical and systemic treatments of psoriatic patients under the Japanese health insurance system. The retrospective study was performed from the database of our clinic, which is located in Hokkaido Prefecture. Cost and effectiveness of psoriatic patients were evaluated during the 12-month period from April 2015 to March 2016. Data were collected and calculated for the total cost per year, treatment efficacy and cost versus efficacy. The mean total cost of topical corticosteroid treatment was ¥18 184/year and was lowest among the treatments. The systemic treatment with biologics was most expensive and the costs were over ¥400 000/year. Among the topical treatments, calcipotriol/betamethasone dipropionate was most expensive (¥34 693/year). However, cost versus efficacy was not significantly different from that of topical corticosteroid treatments. The cost of secukinumab was highest among all the treatments (¥631 600/year). However, treatment day per cost was lowest of all the psoriasis treatments. Biologics showed the highest cost than topical or systemic treatments. However, they showed most marked efficacy in terms of improving the psoriatic skin lesions.

Cost‐efficacy and pharmacoeconomics of psoriatic patients in Japan: Analysis from a single outpatient clinic

“…As expected, biologics showed the highest cost than any topical or other systemic treatments. However, they showed most marked efficacy in terms of improving the psoriatic skin lesions as well as patients’ QOL, compatible with the previous studies …”

“…Among the topical treatments, total cost and actual patient payment of combined corticosteroid/vitamin D 3 was highest. However, the cost versus efficacy in terms of total cost/1 PASI or patient payment/1 PASI was lowest among the topical treatments, compatible with our previous study . Furthermore, combined topical corticosteroid/vitamin D 3 treatment potently increased the EQ‐5D scores.…”

“…Previously, we showed that among topical treatments calcipotriol/betamethasone dipropionate was most expensive. However, the cost versus efficacy was not significantly different from that of topical corticosteroid treatment . The study, however, was performed in a retrospective manner without the evaluation of the patients’ QOL.…”

“…Now, biologics are available showing remarkable efficacy. However, biologics are very expensive and the costs per year are ¥448 550, ¥532 850 and ¥631 600 for secukinumab, ustekinumab and adalimumab, respectively, under the Japanese health‐care insurance system . The topical treatment is still a major treatment for psoriasis.…”

Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents

“…Among them, biologics, which enable approximately 60–70% of psoriatic patients to achieve 90% improvement of Psoriasis Area and Severity Index (PASI‐90), bring the greatest impact on therapeutic strategy of psoriasis to date, and the PASI‐90 or more improvement is closely correlated with significant improvement of patients’ impaired QOL . However, the cost of biologic therapy is generally high, and it is important to select the therapeutic options, including biologics, by considering a patient's disease activity and other personal background . To minimize the economic issue and unfavorable adverse events, dose reduction, elongation of administration interval and discontinuation are possible options but biomarkers indicating deep remission of psoriasis have not been established.…”