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A Journal on Dermatology
Esperienze Dermatologiche 2016 March;18(1):38-44
Psoriasis: cost and impact of the disease on the Italian National Health Service
Gilberto BELLIA 1, Francesca GAIANI 2, Mauro BOVOLENTA 1, Piergiorgio MALAGOLI 2
1 UCB Pharma Italia, Milano, Italia; 2 IRCCS Policlinico San Donato, Milano, Italia
Psoriasis is a chronic inflammatory disease that affects the skin with an incidence, in Western countries, between 1.5% to 4%. The incidence peaks at two points: the first one between 20-30 years and the second between 50-60 years. The “first-line” treatment of the disease are topical drugs, while the “second-line” treatment includes phototherapy and systemic non-biotech drugs (such as cyclosporine A, methotrexate and acitretin). The “third line” treatment is represented by biotechnological drugs (such as etanercept, infliximab, adalimumab, and ustekinumab). This paper analyzes the costs of the management of patients with psoriasis, taking into account direct costs (medication, doctor visits, tests, etc.) and indirect (lost work days, etc.). The analysis of cost-effectiveness studies shows that the health-related costs are closely correlated with disease severity. In Italy the process of “pricing” for the innovative drugs is changing from a system based on the clinical benefit of the drug to a system based on incremental benefit, but also this system has some limitations. A clearer process for the “pricing” of innovative drugs would lead to an improvement of the entire system.