Economic Impact of Timely Systemic Treatment of Psoriatic Disease in Comorbidity Risk Reduction: Literature Review and (Early) Economic Assessment

Psoriatic disease, including psoriasis and psoriatic arthritis, is associated with increased risk of comorbidities (cardiovascular disease, mental health disorders, type 2 diabetes mellitus and obesity), placing substantial burden on patients and health systems. We aimed to quantify the lifetime economic burden of these four comorbidities in populations with moderate-to-severe psoriasis and psoriatic arthritis. We subsequently estimated the potential comorbidity-related gross cost offsets from timely systemic therapy across three diverse country settings (Denmark, the USA and Vietnam). We conducted a literature review to identify data on prevalence, comorbidity risk, treatment-associated risk reduction and cost inputs, followed by development of a static cohort-based economic model from a societal perspective. The model compared untreated/undertreated moderate-to-severe psoriasis/psoriatic arthritis; and systemic treatment scenarios (conventional systemic disease-modifying antirheumatic drugs [csDMARDs]; biologic DMARDs [bDMARDs]; and targeted synthetic DMARDs [tsDMARDs]) over a lifetime horizon in Denmark, the USA and Vietnam, reporting total comorbidity cost offsets across direct (healthcare) and indirect (societal) costs. Systemic treatment reduced lifetime comorbidity-related direct and societal costs across settings. In the USA, patients with moderate-to-severe psoriasis incurred annual direct costs of approximately 4.6 billion USD (indirect 0.6 billion USD), and untreated lifetime burden of about 153.0 billion USD. Treating all patients with bDMARDs yielded an estimated cost offset of 62.9 billion USD in the direct costs and an offset of 8.1 billion USD in the societal costs compared with a fully undertreated population. Equivalent analyses in Denmark and Vietnam reflected similar effects on comorbidity-related costs. The model shows that early systemic therapy yields substantial effect on the direct and societal costs via reduced comorbidity incidence. Timely and efficacious systemic treatment of psoriatic disease can significantly reduce lifetime economic burden of comorbidities across diverse healthcare settings. These findings underscore the value of early, proactive management of psoriatic disease and highlight the need for further cost-effectiveness research, including treatment uptake and real-world comorbidity prevention. Could early systemic treatment reduce the costs of comorbidities linked to psoriatic disease? Psoriatic disease is a chronic inflammatory disease that includes psoriasis (affecting the skin) and psoriatic arthritis (affecting the joints). People with psoriatic disease are also more likely to develop other serious health problems, known as comorbidities, such as cardiovascular disease, type 2 diabetes, obesity, depression and anxiety. These conditions can greatly affect quality of life and increase healthcare costs. In this study, we examined whether treating psoriatic disease earlier and more effectively with systemic treatments (medications that work throughout the body) could reduce the risk and offset the costs of these comorbidities. We reviewed published studies and developed an economic model to estimate the lifetime cost of comorbidities in people with moderate-to-severe psoriasis and psoriatic arthritis in Denmark, the USA and Vietnam and how this burden may differ with early treatment using conventional systemic, biologic, or targeted synthetic therapies. Our findings suggest that early systemic treatment may lower the risks of comorbidities and reduce long-term healthcare costs. Overall, timely and effective treatment of psoriatic disease may improve symptoms of psoriatic disease while also potentially reducing the economic burden on healthcare systems and society.