Budgetary Impact of Generalized Pustular Psoriasis (GPP) in the Brazilian Private Healthcare System: A Real-World Data Analysis
Author(s)
Carlos F. Salgado De Santana, PharmD1, Cinara Soares, MD1, Juliana Nascimento, BSC2, Mariana Araujo, BSC2, Fernandes Taís Bertoldo Teixeira, BSC2.
1Boehringer Ingelheim Brazil, São Paulo, Brazil, 2Orizon Healthtech, Barueri, Brazil.
1Boehringer Ingelheim Brazil, São Paulo, Brazil, 2Orizon Healthtech, Barueri, Brazil.
OBJECTIVES: Generalized pustular psoriasis (GPP) is a rare, chronic, systemic severe inflammatory disease with a heterogenous and unpredictable clinical course. Due to its rarity, GPP remains poorly diagnosed, with limited professional experience, as well as lack of clarity regarding the associated costs and impact on the healthcare system. This study aimed to map the patient journey and estimate the direct economic burden of GPP in the Brazilian private healthcare setting.
METHODS: This is a retrospective cohort study, utilizing extensive administrative claims database representative of Brazil’s private healthcare, covering the period of analysis from January 2010 to December 2023, with patient selection occurring between 2012 and 2021 based on the GPP ICD-10 code L40.1. Each patient was followed for 2 years before and after the first event to evaluate the burden profile. Direct medical costs related to outpatient services, hospitalizations, ICU admissions, diagnostic procedures, and pharmacological treatments were calculated.
RESULTS: A total of 77 GPP patients were identified. Hospitalizations occurred in 58% of patients, with an average of 4 admissions per patient; 78% of these were directly related to GPP. ICU admissions occurred in 36% of patients. The mean cost per hospitalization reached BRL140,213.12, ICU admissions averaged BRL136,931.56. Notably, hospitalization costs peaked one-year post-diagnosis (BRL115,649.68), reflecting a 159% increase compared to the pre-diagnosis period. Outpatient costs also rose, with elective visits increasing from BRL312 to BRL427, and emergency visits from BRL2,152 to BRL2,845 over the follow-up period. The total pharmacological treatment cost reached approximately BRL3.3 million, largely driven by biologics.
CONCLUSIONS: GPP imposes a substantial direct economic burden on the Brazilian private healthcare system, driven by high hospitalization and intensive care costs, alongside elevated pharmacological expenditures. The data reinforce the urgent need for earlier diagnosis, standardized treatment protocols, and improved access to effective therapies to optimize resource utilization and patient outcomes.
METHODS: This is a retrospective cohort study, utilizing extensive administrative claims database representative of Brazil’s private healthcare, covering the period of analysis from January 2010 to December 2023, with patient selection occurring between 2012 and 2021 based on the GPP ICD-10 code L40.1. Each patient was followed for 2 years before and after the first event to evaluate the burden profile. Direct medical costs related to outpatient services, hospitalizations, ICU admissions, diagnostic procedures, and pharmacological treatments were calculated.
RESULTS: A total of 77 GPP patients were identified. Hospitalizations occurred in 58% of patients, with an average of 4 admissions per patient; 78% of these were directly related to GPP. ICU admissions occurred in 36% of patients. The mean cost per hospitalization reached BRL140,213.12, ICU admissions averaged BRL136,931.56. Notably, hospitalization costs peaked one-year post-diagnosis (BRL115,649.68), reflecting a 159% increase compared to the pre-diagnosis period. Outpatient costs also rose, with elective visits increasing from BRL312 to BRL427, and emergency visits from BRL2,152 to BRL2,845 over the follow-up period. The total pharmacological treatment cost reached approximately BRL3.3 million, largely driven by biologics.
CONCLUSIONS: GPP imposes a substantial direct economic burden on the Brazilian private healthcare system, driven by high hospitalization and intensive care costs, alongside elevated pharmacological expenditures. The data reinforce the urgent need for earlier diagnosis, standardized treatment protocols, and improved access to effective therapies to optimize resource utilization and patient outcomes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE115
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)