Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study

Sofia Löfvendahl; Jenny M Norlin; Marcus Schmitt-Egenolf

doi:10.2147/PTT.S359011

Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study

Psoriasis (Auckl). 2022 May 5:12:89-98. doi: 10.2147/PTT.S359011. eCollection 2022.

Authors

Sofia Löfvendahl¹, Jenny M Norlin¹, Marcus Schmitt-Egenolf²

Affiliations

¹ The Swedish Institute for Health Economics (IHE), Lund, Sweden.
² Department of Public Health and Clinical Medicine, Dermatology, Umeå University, Umeå, Sweden.

Abstract

Background: Generalized pustular psoriasis (GPP), which can occur with or without psoriasis vulgaris (PV), is a severe form of pustular psoriasis with potentially life-threatening symptoms. GPP is also associated with several comorbidities, which further adds to the burden of disease. This study investigates the economic burden of disease in patients with GPP.

Methods: All-cause and GPP-specific healthcare resource use (inpatient stays, physician visits and drug use), as well as associated costs, were compared for year 2015 between GPP patients (n = 914) and two matched control groups representing the general population (n = 4047) and patients with PV but no GPP (n = 2556). Information on resource use for 2015 was obtained from the Swedish National Patient Register and Swedish Prescribed Drug Register, respectively.

Results: All-cause inpatient stays, physician visits, and use of psoriasis-related drugs were significantly more common among GPP patients compared to both control groups. This difference was reflected in total direct cost for GPP patients (5062 euros/year) which was 3.1 and 1.8 times higher (p < 0.001) compared to the general population and PV controls, respectively. For GPP patients, the share of total cost was 22% for all-cause physician outpatient visits and 40% for all-cause inpatient stays. However, only 6.3% and 11.3% of these costs, respectively, were due to GPP-specific problems. Psoriasis-related drugs constituted 27% of total costs for GPP patients of which a large fraction (86%) was represented by biologics.

Conclusion: This study demonstrates a higher economic burden for GPP patients compared to both the general population and patients with PV, with inpatient visits and use of biologic drugs as major cost driving factors. Only fractions of the costs for physician visits and inpatient stays were attributable to specific GPP problems, indicating a higher economic burden of GPP-consequences and complications.

Keywords: direct costs; generalised pustular psoriasis; incremental analysis; population-based controls.

Grants and funding

This research is the result of a research platform, which has received financial support from AbbVie, Boehringer Ingelheim, Eli Lilly, Janssen Cilag, Leo Pharma and Novartis. This study’s design and analysis was funded by Boehringer Ingelheim. Sponsors had no access to data. None of the authors has any conflict of interest in connection to the article. The authors had full independence regarding study design, data collection, analysis, result interpretation and decision to publish.