Value in Psoriasis Care: From Patients to Payers

Abstract

The symposium explored new approaches to optimising the value of psoriasis management from the perspective of physicians, patients, and healthcare systems, drawing on research and evidence from real world clinical practice. The value in improving the management of psoriasis means boosting the efficacy of patient management, improving the power of outcomes measurement, raising the quality of care, and working more effectively with payers. Many patients with moderate-to-severe psoriasis do not currently receive high quality care and are often undertreated, with many not receiving systemic therapy despite this being recommended by evidence-based guidelines. Reasons for not initiating or maintaining systemic therapy included long-term safety concerns, convenience of use, and cost, even though psoriasis can result in irreversible cumulative life impairment. The growing recognition that psoriasis is a systemic inflammatory disorder that is associated with a wide range of comorbidities, including obesity, cardiovascular disease, diabetes, hypertension, and depression, underlines the need for systematic evaluation and treatment of comorbidities and the use of systemic treatment. Setting and implementing treatment goals is considered essential for driving up the value of psoriasis care. These should include measures that matter most to patients, taking into account the impact of psoriasis on their quality of life, including involvement of visible areas and nails, pruritus, and recalcitrant plaques, in addition to objective measures such as their Psoriasis Area Severity Index (PASI) score. Comprehensive management of psoriasis should provide treatment or referral to relevant specialists working in an integrated way across a networked service.