OBJECTIVES: The impact of choice of pharmacotherapy for psoriasis on costs and patient outcomes in large nationally representative data in the United States needs further examination. This study examined the impacts of patient demographics and medication choices on patient's health status and associated medication costs in the United States. METHODS: A retrospective cross-sectional study was conducted using the 2007 Medical Expenditure Panel Survey (MEPS) database. Information on patient demographics, health status, medication utilization, and medication costs were obtained from the database representing 605,089 patients with psoriasis. Weighted multiple linear regressions were used to examine the impacts of patient demographics and medication choices on patient's health status and associated medication costs. RESULTS: Weighted multiple linear regression analyses indicated that the use of topical corticosteroids yielded 23.0% lower annual medication costs (compared to nonusers in logarithm format; p = 0.00), whereas the use of biological/systemic agents yielded 41.8% higher annual medication costs (compared to nonusers in logarithm format; p = 0.00.) The study population using topical corticosteroids had 35.0% improvement in SF-12 PCS scores (compared to nonusers; p = 0.00), whereas patients using biological/systemic agents had 8.2% improvement in SF-12 PCS scores (compared to nonusers; p = 0.00.) The use of biological agents was elevated compared to previous studies. CONCLUSIONS: We observed an association with medication choice for psoriasis treatment on associated patient health status and medication spending in the United States. The retrospective nature of the study precludes assessment of causality, but encouraging use of topical treatments may be an effective means to reduce psoriasis management costs.