PSY18 Economic Burden of Psoriasis (PSO) and Obesity in Patients With Psoriasis in the United States

Abstract

To estimate incremental resource use and costs of Pso and obesity in Pso patients. Adult Pso patients (≥2 Pso diagnoses) were selected from a large US claims database (2004-2008). Pso patients were matched (based on age and gender) to Pso-free patients (i.e., without Pso or psoriatic arthritis diagnosis). Obesity was defined based on patients' reported body mass index (BMI≥30). Healthcare resource use and costs were assessed over a one-year period. Incidence rate differences and incremental annual total health care costs (USD 2010; measured from a payer perspective) associated with Pso and obesity between Pso and Pso-free patients were estimated using multivariate Poisson regression models and generalized linear regression models, respectively, controlling for age, gender, and Charlson comorbidity index. A total of 1874 matched pairs with reported BMI were selected. Among Pso patients, 34% were obese compared to 28% of the Pso-free controls (p<0.01). Compared to non-obese Pso patients, obese Pso patients had on average 7 more urgent care visits (hospitalizations and emergency department visits) per 100 patient-years (p =0.02), and 1.8 more outpatient visits per patient-years (p =0.01). Compared to Pso-free patients, Pso was associated with 5.0 more outpatients visits per patient-years in non-obese patients and 6.3 more outpatients visits per patient-year in obese patients (both p <0.01). Among Pso patients, obesity presented a $2,729 incremental cost compared to the non-obese Pso patients ($12,670 vs. $9,192; p<0.01). Compared to Pso-free patients, Pso was associated with a $4,735 incremental total health care cost among non-obese patients ($9,192 vs. $4,681; p<0.01) and a $6,887 incremental cost among obese patients ($12,670 vs. $5,460; p<0.01). The difference ($2152) between $6887 and $4735 was not statistically significant in the final model. Pso patients have higher prevalence of obesity when compared to Pso-free patients. Both Pso and obesity were associated with significant incremental costs.