Shell out $11,498 and you can improve your life with a certified pre-owned Subaru or one month living in a two-bedroom apartment in midtown Manhattan.
But that’s also what people with psoriasis say they would pay over their lifetimes to be free of the physical and emotional effects of the disease, according to a new review published in JAMA Dermatology.
There are between five and seven million Americans living with psoriasis. Currently, the annual cost of the disease for patients, employers, and payers in the United States is between $112 and $135 billion, according to the new study.
Researchers like Dr. April Armstrong, an academic dermatologist with the University of Colorado, arrived at those estimates after reviewing published research from 2008 through 2013. Her analysis takes into account the social, psychological, and financial challenges people with psoriasis face.
“I think these numbers say there’s a great economic burden with psoriasis, and half is a decreased earning potential,” Armstrong told Healthline.
In the studies she examined, patients with psoriasis were willing to pay the most for physical comfort and emotional health, with the ability to work or volunteer coming in second.
The Intangible Costs of Psoriasis
Psoriasis is an inflammatory skin condition that affects about 3.2 percent of Americans over the age of 20. It is associated with a higher risk of cardiovascular events, like heart attack and stroke, along with depression and other psychological distress.
“Psoriasis isn’t skin-limited. It’s systemic,” Armstrong said.
Besides the outward physical symptoms — including red, flaky patches of skin and chronic dandruff — the condition can leave people self-conscious about their appearance and with a low sense of self-esteem. This can cause missed days of work during bad symptom flares and other unforeseen problems that have economic consequences.
Intangible costs — such as difficulty in social interactions and the psychological stress that comes with the disease — were all factored in when calculating the total costs of psoriasis to society, Armstrong said.
“This is a tremendous burden,” she said.
The Cost of Treating Psoriasis
Depending on how a person chooses to treat their psoriasis — topical medications, phototherapy, or systemic therapy — the average psoriasis patient will pay $614 per month. That’s more than twice the cost of care for someone who doesn’t have the condition.
“The direct healthcare costs are significantly greater for patients with psoriasis than for the general population and are also higher for patients with increasing psoriasis disease severity,” researchers said in the study.
The worse a person’s condition gets, the more they can expect to pay. One study researchers reviewed showed that people with severe psoriasis pay significantly more than those with moderate psoriasis.
The existing literature shows that the annual cost of the disease can vary based on the type of treatment. Phototherapy ranges in cost from $1,414 to $7,697. The annual cost per patient is $5,713. The annual cost per patient for traditional systemic drugs is $11,029; biologics cost $26,708.
There weren’t enough available studies to show the cost of topical therapies. These are the most commonly used and the first line of treatment for the newly diagnosed.
Researchers said more investigation is needed to understand the full costs of psoriasis for both patients and the United States as a whole. For instance, there’s a lack of data on prescription drug costs, insurance coverage for various treatments, and what patients pay out of pocket.
“Treatment costs can be difficult to ascertain,” Armstrong said.
Knowing the full economic impact of psoriasis, Armstrong said, will aid in finding cost-effective treatments that can help prevent the escalation of the disease.
Armstrong disclosed in the study she has worked in drug trials for psoriasis drug makers AbbVie, Amgen, Celgene, Janssen, Lilly, Merck, Pfizer, and UCB.