nach oben

The European Journal of Health Economics

Erschienen in:

01.05.2014 | Original Paper

Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres

verfasst von: Orsolya Balogh, Valentin Brodszky, László Gulácsi, Emese Herédi, Krisztina Herszényi, Hajnalka Jókai, Sarolta Kárpáti, Petra Baji, Éva Remenyik, Andrea Szegedi, Péter Holló

Erschienen in: The European Journal of Health Economics | Sonderheft 1/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies.

Objectives

To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary.

Methods

Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures.

Results

Two-hundred patients were involved (females 32 %) with a mean age of 51 (SD 13) years, 103 (52 %) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86 %. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups.

Conclusions

Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.

Parisi, R., Symmons, D.P., Griffiths, C.E., Ashcroft, D.M.: Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J. Invest. Dermatol. 133(2), 377–385 (2013). doi:10.1038/jid.2012.339 PubMedCrossRef

Menter, A., Korman, N.J., Elmets, C.A., Feldman, S.R., Gelfand, J.M., Gordon, K.B., Gottlieb, A., Koo, J.Y., Lebwohl, M., Lim, H.W., Van Voorhees, A.S., Beutner, K.R., Bhushan, R.: Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J. Am. Acad. Dermatol. 60(4), 643–659 (2009). doi:10.1016/j.jaad.2008.12.032 PubMedCrossRef

EMA, C.f.M.P.f.H.U.: Guideline on clinical investigation of medicinal products indicated for the treatment of psoriasis. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/09/WC500003329.pdf (2004)

Menter, A., Korman, N.J., Elmets, C.A., Feldman, S.R., Gelfand, J.M., Gordon, K.B., Gottlieb, A., Koo, J.Y., Lebwohl, M., Leonardi, C.L., Lim, H.W., Van Voorhees, A.S., Beutner, K.R., Ryan, C., Bhushan, R.: Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J. Am. Acad. Dermatol. 65(1), 137–174 (2011). doi:10.1016/j.jaad.2010.11.055 PubMedCrossRef

Richard, M.A., Barnetche, T., Horreau, C., Brenaut, E., Pouplard, C., Aractingi, S., Aubin, F., Cribier, B., Joly, P., Jullien, D., Le Maitre, M., Misery, L., Ortonne, J.P., Paul, C.: Psoriasis, cardiovascular events, cancer risk and alcohol use: evidence-based recommendations based on systematic review and expert opinion. J. Eur. Acad. Dermatol. Venereol. 27(Suppl 3), 2–11 (2013). doi:10.1111/jdv.12162 PubMedCrossRef

Ogdie, A., Haynes, K., Troxel, A.B., Love, T.J., Hennessy, S., Choi, H., Gelfand, J.M.: Risk of mortality in patients with psoriatic arthritis, rheumatoid arthritis and psoriasis: a longitudinal cohort study. Ann. Rheum. Dis. 73(1), 149–153 (2014). doi:10.1136/annrheumdis-2012-202424 PubMedCrossRef

Dhir, V., Aggarwal, A.: Psoriatic arthritis: a critical review. Clin. Rev. Allergy Immunol. 44(2), 141–148 (2013). doi:10.1007/s12016-012-8302-6 PubMedCrossRef

Radtke, M.A., Augustin, M.: Economic considerations in psoriasis management. Clin. Dermatol. 26(5), 424–431 (2008). doi:10.1016/j.clindermatol.2007.10.024 PubMedCrossRef

Raho, G., Koleva, D.M., Garattini, L., Naldi, L.: The burden of moderate to severe psoriasis: an overview. Pharmacoeconomics 30(11), 1005–1013 (2012). doi:10.2165/11591580-000000000-00000 PubMedCrossRef

10.

Herédi, E., Rencz, F., Balogh, O., Gulácsi, L., Herszényi, K., Holló, P., Jókai, H., Kárpáti, S., Péntek, M., Remenyik, É., Szegedi, A., Brodszky, V.: Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary. The European Journal of Health Economics (in press) (2014)

11.

Finlay, A.Y.: Current severe psoriasis and the rule of tens. Br. J. Dermatol. 152(5), 861–867 (2005). doi:10.1111/j.1365-2133.2005.06502.x PubMedCrossRef

12.

Reilly, M.C., Zbrozek, A.S., Dukes, E.M.: The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 4(5), 353–365 (1993)PubMedCrossRef

13.

Finlay, A.Y., Khan, G.K.: Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin. Exp. Dermatol. 19(3), 210–216 (1994)PubMedCrossRef

14.

Kind, P., Dolan, P., Gudex, C., Williams, A.: Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 316(7133), 736–741 (1998)PubMedCentralPubMedCrossRef

15.

Pathirana, D., Ormerod, A.D., Saiag, P., Smith, C., Spuls, P.I., Nast, A., Barker, J., Bos, J.D., Burmester, G.R., Chimenti, S., Dubertret, L., Eberlein, B., Erdmann, R., Ferguson, J., Girolomoni, G., Gisondi, P., Giunta, A., Griffiths, C., Honigsmann, H., Hussain, M., Jobling, R., Karvonen, S.L., Kemeny, L., Kopp, I., Leonardi, C., Maccarone, M., Menter, A., Mrowietz, U., Naldi, L., Nijsten, T., Ortonne, J.P., Orzechowski, H.D., Rantanen, T., Reich, K., Reytan, N., Richards, H., Thio, H.B., van de Kerkhof, P., Rzany, B.: European S3-guidelines on the systemic treatment of psoriasis vulgaris. J. Eur. Acad. Dermatol. Venereol. 23(Suppl 2), 1–70 (2009). doi:10.1111/j.1468-3083.2009.03389.x PubMedCrossRef

16.

Hungarian Central Statistical Office: Gross wages and salaries (2001-2012). http://www.ksh.hu/docs/hun/eurostat_tablak/tabl/tec00014.html (2012). Accessed 1 September 2013

17.

National Health Insurance Fund Administration: Official list of drugs (2012). Accessed 1 Sept 2013

18.

DRG: Disease Related Groups. http://www.gyogyinfok.hu/magyar/hbcs_konyv.html (2011). Accessed 1 Sept 2013

19.

Centre for Budapest Transport. http://www.bkk.hu/en/prices/ (2012). Accessed 1 Sept 2013

20.

Debrecen Transport Services Closed Corporation. http://www.dkv.hu/en/fares (2012). Accessed 1 Sept 2013

21.

Ministry of Health—National Health Insurance Fund’s prospectus of the monthly payment of financing of curative and preventing care. In. (2012)

22.

Koopmanschap, M.A., Rutten, F.F.: A practical guide for calculating indirect costs of disease. Pharmacoeconomics 10(5), 460–466 (1996)PubMedCrossRef

23.

Koopmanschap, M.A., Rutten, F.F., van Ineveld, B.M., van Roijen, L.: The friction cost method for measuring indirect costs of disease. J. Health Econ. 14(2), 171–189 (1995)PubMedCrossRef

24.

Laki, J., Monok, G., Palosi, M., Gajdacsi, J.Z.: Economical aspect of biological therapy in inflammatory conditions in Hungary. Expert Opin. Biol. Ther. 13(3), 327–337 (2013). doi:10.1517/14712598.2013.735654 PubMedCrossRef

25.

Szende, A., Nemeth, R.: Health-related quality of life of the Hungarian population. Orv. Hetil. 144(34), 1667–1674 (2003)PubMed

26.

Ciocon, D.H., Horn, E.J., Kimball, A.B.: Quality of life and treatment satisfaction among patients with psoriasis and psoriatic arthritis and patients with psoriasis only: results of the 2005 Spring US National Psoriasis Foundation Survey. Am. J. Clin. Dermatol. 9(2), 111–117 (2008)PubMedCrossRef

27.

Brodszky, V., Balint, P., Geher, P., Hodinka, L., Horvath, G., Koo, E., Pentek, M., Polgar, A., Sesztak, M., Szanto, S., Ujfalussy, I., Gulacsi, L.: Disease burden of psoriatic arthritis compared to rheumatoid arthritis, Hungarian experiment. Rheumatol. Int. 30(2), 199–205 (2009). doi:10.1007/s00296-009-0936-1 PubMedCrossRef

28.

Fonia, A., Jackson, K., Lereun, C., Grant, D.M., Barker, J.N., Smith, C.H.: A retrospective cohort study of the impact of biologic therapy initiation on medical resource use and costs in patients with moderate to severe psoriasis. Br. J. Dermatol. 163(4), 807–816 (2010). doi:10.1111/j.1365-2133.2010.09944.x PubMedCrossRef

29.

Driessen, R.J., Bisschops, L.A., Adang, E.M., Evers, A.W., Van De Kerkhof, P.C., De Jong, E.M.: The economic impact of high-need psoriasis in daily clinical practice before and after the introduction of biologics. Br. J. Dermatol. 162(6), 1324–1329 (2010). doi:10.1111/j.1365-2133.2010.09693.x PubMedCrossRef

30.

Kimball, A.B., Guerin, A., Tsaneva, M., Yu, A.P., Wu, E.Q., Gupta, S.R., Bao, Y., Mulani, P.M.: Economic burden of comorbidities in patients with psoriasis is substantial. J. Eur. Acad. Dermatol. Venereol. 25(2), 157–163 (2011). doi:10.1111/j.1468-3083.2010.03730.x PubMedCrossRef

31.

Gleason, P.P., Alexander, G.C., Starner, C.I., Ritter, S.T., Van Houten, H.K., Gunderson, B.W., Shah, N.D.: Health plan utilization and costs of specialty drugs within 4 chronic conditions. J. Manag. Care Pharm. 19(7), 542–548 (2013)PubMed

32.

Le Moigne, M., Sommet, A., Lapeyre-Mestre, M., Bourrel, R., Molinier, L., Paul, C., Montastruc, J.L.: Healthcare cost impact of biological drugs compared with traditional systemic treatments in psoriasis: a cohort analysis in the French insurance database. J. Eur. Acad. Dermatol. Venereol. (2013). doi:10.1111/jdv.12318 PubMed

33.

Levy, A.R., Davie, A.M., Brazier, N.C., Jivraj, F., Albrecht, L.E., Gratton, D., Lynde, C.W.: Economic burden of moderate to severe plaque psoriasis in Canada. Int. J. Dermatol. 51(12), 1432–1440 (2012). doi:10.1111/j.1365-4632.2011.05359.x PubMedCrossRef

34.

Ghatnekar, O., Ljungberg, A., Wirestrand, L.E., Svensson, A.: Costs and quality of life for psoriatic patients at different degrees of severity in southern Sweden—a cross-sectional study. Eur. J. Dermatol. 22(2), 238–245 (2012). doi:10.1684/ejd.2011.1635 PubMed

35.

Tang, M.M., Chang, C.C., Chan, L.C., Heng, A.: Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study. Int. J. Dermatol. 52(3), 314–322 (2013). doi:10.1111/j.1365-4632.2011.05340.x PubMedCrossRef

36.

Steinke, S.I., Peitsch, W.K., Ludwig, A., Goebeler, M.: Cost-of-illness in psoriasis: comparing inpatient and outpatient therapy. PLoS ONE 8(10), e78152 (2013). doi:10.1371/journal.pone.0078152PONE-D-13-23199 PubMedCentralPubMedCrossRef

Titel: Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres
verfasst von: Orsolya Balogh
Valentin Brodszky
László Gulácsi
Emese Herédi
Krisztina Herszényi
Hajnalka Jókai
Sarolta Kárpáti
Petra Baji
Éva Remenyik
Andrea Szegedi
Péter Holló
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: The European Journal of Health Economics / Ausgabe Sonderheft 1/2014
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-014-0599-z

Springer Medizin

Abstract

Background

Objectives

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 1/2014

Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics

Statistical and regulatory considerations in assessments of interchangeability of biological drug products

Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists

Health technology assessment in Poland, the Czech Republic, Hungary, Romania and Bulgaria

Transferability of results of cost utility analyses for biologicals in inflammatory conditions for Central and Eastern European countries

Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary