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J Eur Acad Dermatol Venereol. 2015 Dec;29(12):2411-6. doi: 10.1111/jdv.13307. Epub 2015 Sep 15.

The impact of biologic therapy in chronic plaque psoriasis from a societal perspective: an analysis based on Italian actual clinical practice.

Author information

1
Tor Vergata University of Rome, Rome, Italy.
2
Department of Dermatology, Spedali Civili, Brescia, Italy.
3
Department of Dermatology, University of Milan, Milan, Italy.
4
San Gallicano Dermatological Institute, Rome, Italy.
5
Department of Medicine, Dermatology and Venereology Sector, University of Verona, Verona, Italy.
6
Unit of Dermatology, Lucca Hospital, Lucca, Italy.
7
Unit of Dermatology, Department of Medicine, University of Padua, Padua, Italy.
8
Department of Dermatology, Messina Hospital, Messina, Italy.
9
Unit of Dermatology and Venereology, University of Bari, Bari, Italy.
10
Department of Dermatology, Tor Vergata University of Rome, Rome, Italy.
11
Department of Dermatology, Federico II University of Naples, Naples, Italy.

Abstract

OBJECTIVE:

Psoriasis is one of the most common forms of chronic dermatitis, affecting 2-3% of the worldwide population. It has a serious effect on the way patients perceive themselves and others, thereby prejudicing their quality of life and giving rise to a significant deterioration in their psycho-physical well-being; it also poses greater difficulties for them in leading a normal social life, including their ability to conduct a normal working life. All the above-mentioned issues imply a cost for the society. This study proposes to evaluate the impact on societal costs for the treatment of chronic plaque psoriasis with biologics (etanercept, infliximab and adalimumab) in the Italian clinical practice.

METHOD:

A prospective observational study has been conducted in 12 specialized centres of the Psocare network, located throughout Italy. Direct and indirect costs (as well as the health-related quality of life of patients with plaque psoriasis undergoing biologic treatments) have been estimated, while the societal impact has been determined using a cost-utility approach.

RESULTS:

Non-medical and indirect costs account for as much as 44.97% of the total cost prior to treatment and to 6.59% after treatment, with an overall 71.38% decrease. Adopting a societal perspective in the actual clinical practice of the Italian participating centres, the ICER of biologic therapies for treating plaque psoriasis amounted to €18634.40 per QALY gained--a value far from the €28656.30 obtained by adopting a third-party payer perspective.

CONCLUSION:

Our study confirms that chronic psoriasis subjects patients to a considerable burden, together with their families and caregivers, stressing how important it is to take the societal perspective into consideration during the appraisal process. Besides, using data derived from Italian actual practice, treatment with biologics shows a noteworthy benefit in social terms.

PMID:
26370321
DOI:
10.1111/jdv.13307
[Indexed for MEDLINE]

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