Research Centre on Public Health (CESP), University of Milan-Bicocca, 20900, Monza, Italy.
IRCCS Istituto Auxologico Italiano, 20145, Milan, Italy.
Pharmacoeconomics. 2024 Dec;42(12):1329-1343. doi: 10.1007/s40273-024-01428-1. Epub 2024 Aug 24.
Psoriatic arthritis (PsA) is an inflammatory disease characterised by a variety of clinical manifestations. Considering the economic burden posed by PsA and the increasing number of treatment options, economic evaluations are required to better allocate available resources. This work aims to update a previous published literature review on PsA cost-of-illness and cost-effectiveness analysis.
A search was performed of English-language literature between January 2017 and March 20, 2024 in Medline/PubMed, Embase and Cochrane library using the terms 'psoriatic arthritis', 'cost of illness' and 'cost effectiveness'. Data on decision model, time horizon, population, treatment options, perspective, type of costs, relevant results and authors' conclusion were extracted from the reviewed articles. Finally, the quality of the included studies was evaluated.
Twenty-seven studies met the inclusion criteria: 16 cost-of-illness and 11 cost-effectiveness/cost-utility analyses. PsA is characterised by high direct and indirect costs. Drug costs as well as hospitalisation and absenteeism were the major drivers of the observed costs. The cost-effectiveness analyses reported the dominance or the cost effectiveness of biologic therapies compared with non-biologic PsA treatment. Biological options like bimekizumab and ixekizumab have demonstrated a better cost-effectiveness profile in PsA patients compared with other treatments (i.e., other biological treatments).
There was an increased number of economic evaluations compared with the previous review. PsA is still associated with significant economic burden worldwide. The main cost was represented by therapies, specifically biological therapies. Amongst the biological therapies, bimekizumab and ixekizumab appear to provide the most economic benefit. Finally, new economic studies are needed to enrich knowledge on the economic burden of subgroups of PsA patients as well as early treatment of PsA with new therapies.
银屑病关节炎（PsA）是一种以多种临床表现为特征的炎症性疾病。考虑到 PsA 带来的经济负担以及不断增加的治疗选择，需要进行经济评估以更好地分配现有资源。本研究旨在更新之前关于 PsA 疾病成本和成本效益分析的文献综述。
使用“psoriatic arthritis”、“cost of illness”和“cost effectiveness”等术语，在 Medline/PubMed、Embase 和 Cochrane 图书馆中对 2017 年 1 月至 2024 年 3 月 20 日的英文文献进行了搜索。从综述文章中提取了决策模型、时间范围、人群、治疗选择、视角、成本类型、相关结果和作者结论等数据。最后，评估了纳入研究的质量。
符合纳入标准的研究有 27 项：16 项疾病成本研究和 11 项成本效益/成本效用分析。PsA 具有较高的直接和间接成本。药物成本以及住院和旷工是导致观察到的成本的主要驱动因素。成本效益分析报告了与非生物性 PsA 治疗相比，生物疗法具有优势或成本效益。与其他治疗方法（即其他生物治疗）相比，bimekizumab 和 ixekizumab 等生物制剂在 PsA 患者中具有更好的成本效益。
与之前的综述相比，本研究中经济评估的数量有所增加。PsA 仍然给全球带来了巨大的经济负担。主要成本来自治疗，特别是生物治疗。在生物治疗中，bimekizumab 和 ixekizumab 似乎提供了最大的经济效益。最后，需要新的经济研究来丰富关于 PsA 患者亚组的经济负担以及新疗法早期治疗 PsA 的知识。
