OBJECTIVES: This study aimed to assess therapeutic strategies in clinical practice for patients with psoriatic arthritis (PsA) or psoriasis and calculate related healthcare resources consumption. METHODS: An observational retrospective cohort analysis was conducted based on administrative databases from 2 Italian local health units (LHUs), ≈1.6 million beneficiaries. Citizens who were diagnosed with PsA or psoriasis and had a biologic prescription from January 1, 2010, to December 31, 2013 (index date) were included. Patients were classified as biologic-naïve or biologic-established according to previous biologic treatment, and analysed 1 year back to assess resource consumption in the 2 groups. RESULTS: According to findings from the 2 LHUs, 86% of biologic-naive patients had previous disease-modifying anti-rheumatic drug (DMARD) prescriptions and 47% had previous topical anti-psoriatic prescriptions. Exposure to DMARDs and anti-psoriatic drugs was lower in biologic-established patients (43% and 33%, respectively). Yearly incidence of disease-related hospitalisations before the index date was 7% in biologic-naive and 13% in biologic-established patients. Biologic-naïve patients had longer average hospital lengths of stay. The average cost of illness in the 12 months before the first biologic prescription (biologic-naïve) was ≈760€, with 530€ for DMARDs, 130€ for anti-psoriatics, and 101€ for inpatient stays. Non-PsA/psoriasis-related costs were 790€, of which 57% were due to hospitalisations. Biologic-established patients’ yearly expenditure accounted for 10,410€ for biologic treatment, 265€ for other PsA/psoriasis drugs (168€ DMARDs, 70€ anti-psoriatics, 26€ corticosteroids), and 410€ for hospitalisations. Non-disease-related expenditure was 630€, with >80% due to drug consumption. CONCLUSIONS: At the index date, consumption of DMARDs and other anti-psoriatics was lower in biologic-established than biologic-naïve patients (43% vs 86% and 33% vs 47%, respectively), but overall drug expenditure was higher due to biologic acquisition cost (10,410€ vs 760€). Disease-related hospitalisations were higher in biologic-established patients treated the year before the index date (13% vs 7% of biologic-naïve patients).