OBJECTIVES: Despite well-documented safety and tolerability issues associated with traditional systemic therapies, there remain barriers to biologic uptake in many moderate and severe psoriasis patients. This analysis assesses the level of treatment satisfaction with patient burden, namely work/activity impairment and emotional wellbeing, in 445 patients currently receiving traditional systemic therapy who are eligible for, but not receiving, biologic therapy. METHODS: Data were extracted from the Adelphi Real World Psoriasis Disease-Specific Programme®, a cross-sectional survey of 292 dermatologists and their patients conducted in early 2011 in France, Germany, Italy, Spain and the UK. Each dermatologist completed patient record forms for their seven most recently seen patients. Patients were invited to complete a questionnaire, including questions on satisfaction and validated instruments WPAI (Work Productivity and Activity Impairment) & PHQ9 (personal health questionnaire). Patient inclusion criteria were based on being eligible to receive biologic therapy defined by: Body Surface Area ever exceeding 10%, ever having moderate or severe disease (physician assessment), or ever having received a traditional systemic or biologic treatment. RESULTS: Patient reported satisfaction levels show 58.7% (n=261) satisfied (SAT) and 41.3% (n=184) dissatisfied (DIS) with current treatment. Results from the WPAI questionnaire (n=177) implied worse average results for those dissatisfied with current treatment, DIS 30.40 v SAT 17.12 (Mean Difference (MD) -10.53). PHQ9 (n=442) also found worse outcomes for dissatisfied patients; SAT 3.57 v DIS 6.01 (MD -1.94).  All reported figures have P-values <0.05; MD incorporate confounding factors; age, severity and BSA. CONCLUSIONS: This analysis provides insight into the divergence in burden of disease amongst psoriasis patients, with patients dissatisfied with current systematic regimen suffering greater implied levels of burden than satisfied patients. There is scope to develop this further to better understand the implications of treatment dissatisfaction in this population.