OBJECTIVES: The costs of psoriasis (PsO) and psoriatic arthritis (PsA) are substantial for both patients and the U.S. health care system. This study compared the real-world healthcare resource use and costs among patients with PsO, PsA, and patients without PsO and PsA.

METHODS: The IBM MarketScan Commercial Database identified three adult patient groups from 01/01/2009 through 04/30/2019: 1) PsO: ≥1 inpatient or 2 outpatient diagnoses for PsO (none for PsA); 2) PsA: ≥1 inpatient or 2 outpatient diagnoses for PsA; 3) Control: no PsO or PsA diagnoses. Controls were matched to PsO and PsA patients based on age, gender, and number of non-rheumatological comorbidities. Healthcare resource use and costs (in 2018 USD) were evaluated descriptively and through mixed models for five years of follow-up.

RESULTS: 204,062 PsO and 33,145 PsA patients were matched to the control group (N=237,207). Mean age at baseline (46.4 years ± 11.9) and gender (46.2% male) were comparable among the groups. Annual all-cause healthcare costs per patient were $8,485, $11,695, and $26,393 for the control, PsO, and PsA group, respectively. All-cause healthcare costs and outpatient pharmacy costs increased over time and, compared to the control group, were significantly greater among PsO patients (p<0.001) and PsA patients (p<0.001). Outpatient pharmacy costs represented 19%, 34%, and 53% of annual total costs in the control, PsO, and PsA group, respectively. Healthcare resource use was greatest among patients with PsA and lowest in the control group for the following: inpatient hospitalizations, physician office visits, and hospital outpatient, radiology, emergency room, laboratory, and outpatient pharmacy services.

CONCLUSIONS: A diagnosis of PsA is associated with significantly higher healthcare resource utilization and costs than patients without PsO and PsA diagnosis, and these costs increase over time. The cost disparity between these patient groups highlights the remaining unmet medical need for patients.