Lifetime risk, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for psoriasis in Taiwan: a nationwide cohort followed from 2000 to 2017

Hsien-Yi Chiu; Joung-Liang Lan; Ying-Ming Chiu

doi:10.1177/20406223231168488

Lifetime risk, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for psoriasis in Taiwan: a nationwide cohort followed from 2000 to 2017

Ther Adv Chronic Dis. 2023 Apr 28:14:20406223231168488. doi: 10.1177/20406223231168488. eCollection 2023.

Authors

Hsien-Yi Chiu^{1

2

3

4}, Joung-Liang Lan^{5

6

7}, Ying-Ming Chiu^{8

9

10}

Affiliations

¹ Department of Dermatology, National Taiwan University Hsin-Chu Hospital, Hsinchu.
² Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu.
³ Department of Dermatology, National Taiwan University Hospital, Taipei.
⁴ Department of Dermatology, College of Medicine, National Taiwan University, Taipei.
⁵ Rheumatology and Immunology Center, China Medical University Hospital, Taichung City.
⁶ Department of Medicine, China Medical University, Taichung City.
⁷ Hsien-Yi Chiu is also affiliated to Department of Medical Research, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
⁸ Department of Allergy, Immunology, and Rheumatology, Tungs' Taichung MetroHarbor Hospital, No. 699, Section 8, Taiwan Boulevard, Wuqi District, Taichung City 43503.
⁹ Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli.
¹⁰ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City.

Abstract

Background: Patients with psoriasis have a significant disease burden throughout the life course. Nevertheless, the lifetime risk and disease burden of psoriasis across the entire lifespan is rarely quantified in an easily understandable way.

Objective: To estimate the cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for incident psoriasis.

Design and methods: Using real-world nationwide data from the National Health Insurance Research Database of Taiwan for 2000-2017, along with the life tables of vital statistics, we estimated cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for those with psoriasis using a semi-parametric survival extrapolation method.

Results: A total of 217,924 new psoriasis cases were identified. The lifetime risk of psoriasis in patients aged 18-80 for both sexes decreased in Taiwan with a cumulative incidence rate of 7.93% in 2000 to 3.25% in 2017. The mean (±standard error) life expectancy after diagnosis was 27.11 (± 1.15) and 27.14 (±1.17) years for patients with moderate-to-severe psoriasis and psoriatic arthritis, respectively. Patients with moderate-to-severe psoriasis and psoriatic arthritis had a mean (±standard error) loss-of-life expectancy of 6.41 (±1.16) and 6.48 (±1.17) due to psoriasis, respectively. Male patients have higher lifetime and annual lifetime healthcare expenditures than female. Mean life expectancy, loss-of-life expectancy, and lifetime cost were relatively higher for younger patients.

Conclusion: Among psoriatic patients, patients with moderate-to-severe psoriasis and psoriatic arthritis had substantial years of life lost, particularly for younger patients. Our results provide a reliable estimation of lifetime disease burden, and these estimates will help health authorities in cost-effectiveness assessments of public health interventions and allocation of services resources to minimize loss-of-life expectancy, and lifetime healthcare expenditures in patients with psoriasis.

Keywords: disease burden; healthcare expenditures; life expectancy; loss-of-life expectancy; psoriasis; risk.