OBJECTIVES: Psoriasis (PSO) and psoriatic arthritis (PsA) are immune-mediated systemic inflammatory diseases; adalimumab (ADA) and etanercept (ETN) are among the most commonly used first-line biologic agents. As per FDA-approved dosage and administration, newly initiated PSO patients receive a higher loading dose followed by a regular maintenance dose. In clinical practice, however, patients may receive higher than recommended (increased) doses even during the maintenance phase of treatment. Given linear pricing of these medications, our objective was to determine if the increased dosing schedule increases payer costs and to what degree. METHODS: Continuously enrolled adult patients with ≥2 outpatient diagnoses of PSO (ICD-9 code: 696.1) or PsA (ICD-9 code: 696.0) were selected from the Symphony PTD Claims Database if their first biologic prescription date (index date) fell between May 2010 and April 2013. Patients were required to be treatment-naïve only to ADA or ETN pre-index. The cost analysis took place over 12 months post-index. Regular (increased) maintenance dosing was defined as ADA 40 mg (>40 mg) biweekly starting 1 week post-index and ETN 50 mg (>50 mg) weekly starting 3 months post-index. Costs were imputed based on 2015 wholesale acquisition costs: $36.4/mg of ADA and $14.9/mg of ETN.  RESULTS: