OBJECTIVES: Published data regarding indirect (or work-related productivity) costs in psoriasis are limited. We sought to estimate indirect costs of moderate-to-severe plaque psoriasis dependent on the level of psoriasis improvement (Psoriasis Activity Severity Index [PASI] change) due to treatment.
METHODS: Work Productivity and Activity Impairment Questionnaire Psoriasis (WPAI-PSO) data from a recent clinical trial (CLEAR) were analyzed by PASI change at 16 weeks. Using reported data for work impairment due to psoriasis for trial subjects who were employed at baseline and data from national employment averages (full- vs. part-time employment, work hours/week, hourly wages), we estimated weekly and annual indirect costs by PASI change for moderate-to-severe plaque psoriasis patients in Germany.
RESULTS: Overall work impairment due to psoriasis decreased with greater skin clearance (PASI change less than 50=23.8%, 50-74=13.3%, 75-89=6.4%, greater than or = 90=4.9%), with the majority of impairment being related to productivity loss at work (presenteeism) rather than absenteeism. On average, patients working with poorly controlled (PASI change <50) moderate-to-severe psoriasis lost greater than 8 hours a week of productive work time due to psoriasis symptoms; while productivity loss for patients with high clearance (PASI change greater than or = 90) was small (less than 2 hours/week). From a societal perspective (includes patients not working), indirect costs per patient per week were estimated to be €117 for PASI change less than 50, €68 for 50-74, €33 for 75-89, and €25 for ≥90. Restricting the population to those employed at baseline (employer’s perspective), indirect costs per employed patient per week decreased from €174 (PASI change less than 50) to €38 (PASI change greater than or = 90). Annual indirect costs from the societal perspective decreased from €6,080 (PASI change less than 50) to €1,316 (PASI change greater than or = 90) per patient.
CONCLUSIONS: Based on our estimates, PASI improvement of ≥90 is linked to a prominent increase in workplace productivity and reduction in indirect costs in moderate-to-severe psoriasis patients from both the societal and employer perspectives.
