OBJECTIVES: To explore disease severity and Dermatology Life Quality Index (DLQI) score as determinants of patient and physician treatment satisfaction, comparing patients across treatment groups in the US and European Union Five (EU5) countries. METHODS:  This is a retrospective study of eligible adult patients with psoriasis and their consulting Dermatologists from the 2015 Adelphi Psoriasis Disease Specific Program (DSP). Patients’ self-reported responses for the DLQI, a validated questionnaire of 10 items with a composite score of 0-30, used to measure quality-of-life (QoL). Higher scores indicate more severe QoL impairment. Physicians and patients self-reported treatment satisfaction, and physicians reported severity using Body Surface Area (BSA) measurement. Study groups considered included patients receiving no therapy, topical/phototherapy, conventional systemic agents, and biologic therapies. Statistical analyses controlling for patient and physician demographics and clinical characteristics were conducted. RESULTS:  1,651 patients (23.9% US and 76.1% EU5) and 282 physicians completed paired responses. From the patient sample, 44.6% were female, and mean age and DLQI score were 44.6 years and 5.2, respectively. From the physician sample, 45.6% were female and median time in practice was 14 years. Median baseline BSA involvement for patient respondents was 18%. Patients satisfied with biologics showed lower DLQI scores (Mean: 3.21; 95%CI: 2.85-3.56) compared to patients not satisfied with biologics (Mean: 9.11; 95%CI: 8.29-9.93). Itching, soreness, pain, and stinging of the skin contributed most to overall DLQI score among unsatisfied patients. Comparing across treatment groups, patients not satisfied with current therapy had mean DLQI scores ranging from 8.9-13.25 after treatment. Greater proportions (75-93%) of unsatisfied patients across treatment groups had a BSA of moderate to severe psoriasis (BSA>3%) after treatment. CONCLUSIONS:  Patients unsatisfied with current treatment reported higher DLQI scores/worse QoL and higher BSA severity across treatment groups, which may indicate that there remains an unmet medical need for psoriasis patients.