OBJECTIVES: To compare time on treatment and time to the next treatment initiation among patients receiving phototherapy, systemic non-biologic therapy (NBT), and biologic therapy after psoriasis diagnosis. METHODS: Adults with ≥2 psoriasis diagnoses and ≥1 systemic or phototherapy claim over the 5 years (study period) after the first psoriasis diagnosis date were selected from a claims database (01/1998-03/2015). Up to 5 treatments (phototherapy, NBT, and biologics) over the study period were assessed. A new treatment was identified as initiating a different treatment, re-initiating the same treatment after a gap of 90+ days, adding a different agent to the existing treatment, or discontinuing an agent from the existing treatment. Time on treatment, time to therapy change, and time from end of treatment to the next treatment initiation were examined. RESULTS: A total of 1,098 adults were included with a mean age of 53 years, 54% men, and 38% having preferred provider organization plan. A total of 44%, 38%, and 17% patients received phototherapy, NBT, and biologics as initial treatment, respectively. The mean time (months) on 1^st treatment was significantly longer for biologics (20.4), compared with NBT (10.4) and phototherapy (5.2). Similarly, the mean time (months) to therapy change was longer for biologics (16.4) compared to phototherapy (7.0) and NBT (9.9). The mean time (months) from end of 1^st treatment to 2^nd treatment initiation was longer for phototherapy (9.5) and NBT (6.8) compared to biologics (4.0) (all p<0.05). Similar patterns were observed for some of the subsequent treatments. For all treatments except phototherapy, the mean time on treatment decreased from 1^st to subsequent treatments. CONCLUSIONS: Among patients with moderate-to-severe psoriasis, those on biologics generally stayed on treatment longer. After discontinuing the 1^st treatment, biologics users moved faster to the next treatment. Time on treatment was shorter for later treatments than 1^st treatment.