OBJECTIVES: Psoriasis (PSO) is an immune-mediated systemic inflammatory disease. The therapeutic classes available to treat PSO include biologic drugs. Despite rising wholesale acquisition costs of biologics in recent years, little documented evidence is available on cost trends from the US managed care perspective. This analysis determines the change in healthcare costs for PSO patients to managed care organizations.  METHODS: Continuously enrolled adult patients with ≥2 outpatient diagnoses for PSO (ICD-9: 696.1) were selected from the MarketScan Commercial and Medicare Supplemental databases if their first biologic prescription date (index date) occurred July 2008 through July 2013 and they were biologic naive ≥6 months pre-index. Healthcare costs were based on annual reimbursements for 6 patient cohorts initiating biologic therapy from 2008 to 2013. Results were stratified by all-cause vs. PSO-related costs and further subdivided into medical inpatient, medical outpatient, emergency room, and pharmacy costs.  RESULTS: