OBJECTIVES: To estimate annual tumor necrosis factor (TNF)-blocker cost per treated psoriatic arthritis (PsA) patient for etanercept, adalimumab, and infliximab using drug utilization from a US managed care population.  METHODS: MarketScan Commercial Database was used to identify PsA patients, 18-64 years old, with ≥1 etanercept, adalimumab, or infliximab claim between November 1, 2005 and June 30, 2009. Patients were continuously enrolled for 1 year after the initial TNF-blocker claim (index). Six months prior to index (pre-index period) was required to identify new (no TNF-blocker claim) or continuing (had a TNF-blocker claim) patients. Patients were excluded if they had other TNF-blocker-indicated conditions during the pre-index period. Mean monthly dose was calculated for the three TNF-blockers while patients were on therapy. 2011 wholesale acquisition costs were applied to the mean monthly dose and the Medicare Physician Fee Schedule was applied to related TNF-blocker administrations to estimate cost per treated patient.   RESULTS: Overall, 2,242 etanercept, 674 adalimumab, and 376 infliximab PsA patients were included. Patient characteristics were similar across treatment groups with a mean age (SD) of 48 (10) years and 54% male. The annual TNF-blocker cost per treated patient for all PsA patients was $15,790 for etanercept, $18,031 for adalimumab, and $26,973 for infliximab. The annual TNF-blocker cost per treated patient for new PsA patients was $14,675 for etanercept, $17,133 for adalimumab, and $23,886 for infliximab. For PsA patients continuing treatment, the annual TNF-blocker cost per treated patient was $16,195 for etanercept, $19,575 for adalimumab, and $28,663 for infliximab. CONCLUSIONS: Based on actual drug utilization from a US managed care population, TNF-blocker cost per treated PsA patient on adalimumab and infliximab were approximately 14% and 71% higher, respectively, than TNF-blocker cost per treated PsA patient on etanercept; patients on etanercept had the lowest TNF-blocker cost per treated PsA patient.