Wagner Jan Nicolai, Hagenström Kristina, Müller Katharina Sophia, Stephan Brigitte, Augustin Matthias, von Kiedrowski Ralph
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Dermatologische Spezial- und Schwerpunktpraxis, Dr. Ralph von Kiedrowski, Selters, Germany.
Psoriasis (Auckl). 2025 Aug 5;15:327-338. doi: 10.2147/PTT.S531836. eCollection 2025.
Psoriasis vulgaris is a chronic systemic inflammatory disease that imposes a significant physical, emotional, and social burden on affected individuals. There is a growing recognition of the importance of comprehensive monitoring and management to optimize treatment outcomes, particularly with the advent of advanced systemic therapies. This study aims to characterize the prevalence of laboratory monitoring and associated costs in persons with psoriasis undergoing systemic treatment. A specific focus was placed on the differences by treatment modality, patient characteristics, and economic burden to the payers.
A retrospective longitudinal analysis was conducted using German health insurance data from the DAK-Gesundheit. The study population included persons diagnosed with psoriasis who received systemic therapies between 2016 and 2020. Laboratory service utilization and costs were assessed during the initiation and course of treatment, factoring in demographic parameters and comorbidities.
Among 62,063 persons with psoriasis, 8018 (12.9%) were identified as having received systemic treatment, which of 92.5% utilized at least one laboratory service. The average annual laboratory monitoring cost per person was higher for those on biologic therapies (57.88 €) compared to systemic treatments (23.70 €). Laboratory service utilization and costs were associated with the comorbidity index (CCI) and age.
Biologic therapies for psoriasis induce considerably higher monitoring costs than non-biological systemic drugs. Age and CCI were main predictors for higher utilization of laboratory services, indicating a medical rationale to perform more lab screenings in risk groups for safety events. The laboratory costs add to the higher drug costs of biologicals but need to be related to the benefits from treatment. Furthermore, the monitoring costs are far lower than the drug costs and thus may not be major decision drivers.
寻常型银屑病是一种慢性全身性炎症性疾病,给患者带来了巨大的身体、情感和社会负担。随着先进的全身治疗方法的出现,人们越来越认识到全面监测和管理对于优化治疗效果的重要性。本研究旨在描述接受全身治疗的银屑病患者的实验室监测患病率及相关费用。特别关注治疗方式、患者特征以及对支付方的经济负担方面的差异。
使用德国DAK-Gesundheit医疗保险数据进行回顾性纵向分析。研究人群包括2016年至2020年间被诊断为银屑病并接受全身治疗的患者。在治疗开始和过程中评估实验室服务的使用情况和费用,同时考虑人口统计学参数和合并症。
在62,063例银屑病患者中,8063例(12.9%)被确定接受了全身治疗,其中92.5%至少使用了一项实验室服务。与全身治疗(23.70欧元)相比,接受生物治疗的患者人均每年实验室监测费用更高(57.88欧元)。实验室服务的使用情况和费用与合并症指数(CCI)和年龄相关。
银屑病的生物治疗比非生物全身药物导致的监测费用高得多。年龄和CCI是实验室服务更高使用率的主要预测因素,这表明在安全事件风险较高的人群中进行更多实验室筛查有医学依据。实验室费用增加了生物制剂更高的药物成本,但需要与治疗带来的益处相关联。此外,监测费用远低于药物成本,因此可能不是主要的决策驱动因素。