Original articleEstimated cost efficacy of systemic treatments that are approved by the US Food and Drug Administration for the treatment of moderate to severe psoriasis
Section snippets
Methods
A literature review of PubMed was performed regarding the efficacy of all systemic medications that are currently approved by the FDA for the treatment of psoriasis (ie, narrowband ultraviolet B light phototherapy [NBUVB], psoralen plus ultraviolet A light phototherapy [PUVA], acitretin, methotrexate, cyclosporine, etanercept, adalimumab, infliximab, and ustekinumab) with the search terms “psoriasis” and “PASI 75” published between 1991 and 2013. Preference for inclusion was given to randomized
Results
Twenty-six studies encompassing 39 treatment regimens (7099 patients) met our search criteria (Table I). The medication, office visit, and laboratory costs per treatment period for each of the 39 studies are shown in Table II. Methotrexate, cyclosporine, and acitretin generally require more frequent office visits than phototherapy and biologic medications. While baseline laboratory costs are generally similar across all the medications except for phototherapy, monitoring laboratory costs are
Discussion
One of the many important factors to deliberate before choosing a treatment for patients with psoriasis is cost, given that therapy and work loss estimates are $1500 annually per psoriasis patient.3 This number may actually be higher; a recent study found an average annual out of pocket cost for psoriasis patients of >$2500.4 In addition, a cost analysis of systemic therapies conducted between 2000 and 2008 revealed that medication prices are increasing at a rate greater than that of general
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Funding sources: None.
Dislcosure: Dr Payette has been an adviser to Amgen. Dr D'Souza declared no conflicts of interest.