Polistena B, Calzavara-Pinton P, Altomare G, Berardesca E, Girolomoni G, Martini P, Peserico A, Puglisi Guerra A, Spandonaro F, Vena Gino A, Chimenti S, Ayala F
Tor Vergata University of Rome, Rome, Italy.
Department of Dermatology, Spedali Civili, Brescia, Italy.
J Eur Acad Dermatol Venereol. 2015 Dec;29(12):2411-6. doi: 10.1111/jdv.13307. Epub 2015 Sep 15.
Psoriasis is one of the most common forms of chronic dermatitis, affecting 2-3% of the worldwide population. It has a serious effect on the way patients perceive themselves and others, thereby prejudicing their quality of life and giving rise to a significant deterioration in their psycho-physical well-being; it also poses greater difficulties for them in leading a normal social life, including their ability to conduct a normal working life. All the above-mentioned issues imply a cost for the society. This study proposes to evaluate the impact on societal costs for the treatment of chronic plaque psoriasis with biologics (etanercept, infliximab and adalimumab) in the Italian clinical practice.
A prospective observational study has been conducted in 12 specialized centres of the Psocare network, located throughout Italy. Direct and indirect costs (as well as the health-related quality of life of patients with plaque psoriasis undergoing biologic treatments) have been estimated, while the societal impact has been determined using a cost-utility approach.
Non-medical and indirect costs account for as much as 44.97% of the total cost prior to treatment and to 6.59% after treatment, with an overall 71.38% decrease. Adopting a societal perspective in the actual clinical practice of the Italian participating centres, the ICER of biologic therapies for treating plaque psoriasis amounted to €18634.40 per QALY gained--a value far from the €28656.30 obtained by adopting a third-party payer perspective.
Our study confirms that chronic psoriasis subjects patients to a considerable burden, together with their families and caregivers, stressing how important it is to take the societal perspective into consideration during the appraisal process. Besides, using data derived from Italian actual practice, treatment with biologics shows a noteworthy benefit in social terms.
银屑病是慢性皮炎最常见的形式之一，影响着全球2%-3%的人口。它对患者如何看待自己和他人产生严重影响，从而损害他们的生活质量，并导致其身心健康显著恶化；这也给他们正常的社会生活带来更大困难，包括正常工作生活的能力。上述所有问题都给社会带来了成本。本研究旨在评估在意大利临床实践中，使用生物制剂（依那西普、英夫利昔单抗和阿达木单抗）治疗慢性斑块状银屑病对社会成本的影响。
在意大利各地的12个Psocare网络专业中心进行了一项前瞻性观察研究。估算了直接和间接成本（以及接受生物治疗的斑块状银屑病患者的健康相关生活质量），同时使用成本-效用方法确定了社会影响。
非医疗和间接成本在治疗前占总成本的44.97%，治疗后占6.59%，总体下降了71.38%。在意大利参与中心的实际临床实践中采用社会视角，治疗斑块状银屑病的生物疗法的增量成本-效果比为每获得一个质量调整生命年18634.40欧元——这一数值与采用第三方支付者视角获得的28656.30欧元相差甚远。
我们的研究证实，慢性银屑病给患者及其家庭和护理人员带来了相当大的负担，强调了在评估过程中考虑社会视角的重要性。此外，根据意大利实际实践得出的数据，生物制剂治疗在社会层面显示出显著益处。
