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Comorbidities of Psoriasis Create Higher Healthcare Costs: Presented at EADV

By Jenny Powers

BERLIN -- October 13, 2009 -- Patients with psoriasis and at least 1 comorbidity are a higher economic burden than patients with psoriasis and no comorbidity, according to research presented at the 18th Congress of the European Academy of Dermatology and Venereology (EADV).

It has been previously established that psoriasis patients have a significantly higher rate of comorbidities, including a higher rate of cardiovascular disease, than their counterparts in the general population.

Lead investigator Alexandra B. Kimball, MD, MPH, Harvard Medical School, Boston, Massachusetts, presented results here on October 8 from an analysis of 114,512 psoriasis patients to determine the impact of comorbidities on the healthcare system. The primary aim of the study was to estimate the incremental economic burden associated with comorbidities in psoriasis patients.

The authors used the Ingenix Impact National Managed Care Database (1999-2004) to analyse the records of adult psoriasis patients who were continuously enrolled for at least 6 months. The comorbidities were psoriatic arthritis, cardiovascular disease, depression, diabetes, hyperlipidaemia, hypertension, obesity, cerebrovascular disease, and peripheral vascular disease.

The economic parameters compared were resource utilisation and costs during the study period for patients with at least 1 psoriasis diagnosis who were then stratified by each reported comorbidity. Adjusted incidence rate ratios (IRRs) and odds ratios (ORs) were estimated for resource utilisation.

Of a total of 114,512 patients, 51% had at least 1 study comorbidity; hyperlipidaemia (27%) and hypertension (25%) were the most prevalent.

It was determined that patients with comorbidities were more likely than patients without comorbidities to experience urgent care (OR = 1.58; 95% confidence interval [CI], 1.51-1.65), be hospitalised (IRR = 2.27; 95% CI, 2.13-2.42), and have more frequent outpatient visits (IRR = 1.53; 95% CI, 1.52-1.55).

Patients with cardiovascular disease experienced a rate of hospitalisation more than 4 times greater (IRR = 4.19; 95% CI, 3.90-4.50) than that of patients without any comorbidities.

A total of $2,184.00 (P < .001) more in total costs was incurred by patients with comorbidities, which were highest in patients with cerebrovascular disease ($6,191.00; P < .001).

The authors concluded that patients with psoriasis and at least 1 comorbidity experienced higher rates of hospitalisation and medical utilisation associated with increased healthcare costs, compared with patients with psoriasis who had no comorbidity.

Funding for this study was provided by Abbott Laboratories.

[Presentation title: Economic Burden of Comorbidities in Psoriasis Patients. Abstract P1171]

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