OBJECTIVES: Biologic treatment for severe forms of psoriasis proved to be effective and safety treatment in clinical trials. However, these drugs comprise a great financial burden. Therefore, we examined etanercept for treatment of severe forms of psoriasis in real clinical practice. METHODS: This was a prospective cohort non-interventional study of phase IV in real clinical practice which included 149 patients enrolled for 6 months. Patients´ data were collected via electronic questionnaire. Clinical data (PASI score and BSA index), direct cost (inpatient and outpatient care, diagnostics, joint replacement etc.) and on QoL (expressed with EQ-5D and DLQI) were collected by dermatologists. Results were evaluated in months 0, 3 and 6 of etanercept treatment. RESULTS: Average patients´ age was 46.74 years (21-75 years), average time from diagnosis was 24.5 years. Occurrence of psoriatic arthritis was 31.7%. 14.6% of patients were work disabled and 16.3% reported incapacity to work with average duration of 44.3 days in previous 6 months. Previous biologic treatment: 46.6% of patients were naive, 16.8% were after previous failure and 36.5% were after successfully finished treatment with biologics within 6 previous months. Within the observation in 0, 3 and 6 months BSA index decreased from 27.12 to 18.64 to 11.47% and PASI score from 13.69 to 8.09 to 4.97. Utility measured according to EQ-5D increased from 0.7674 to 0.8344 and 0.859 and DLQI index decreased from 10.74 to 6.33 and 4.24 in months 0, 3 and 6. Percentage of patients required inpatient care decreased from 25.8 to 5.0 to 0.66%, additionally average length of stay had shortened from 15.9 to 11 days. CONCLUSIONS: Significant clinical effect was observed within 3 and 6 months of etanercept treatment. QoL was increased in vast majority of patients. Treatment with etanercept decreased other costs associated with psoriasis – inpatient care (frequency and length).