BERLIN — More than half of psoriasis patients in a large managed care database had at least one nondermatologic comorbidity, reported Dr. Alexa Boer Kimball.
The psoriasis patients with comorbid conditions imposed a significant economic burden above and beyond that of patients with psoriasis of comparable severity but no comorbidities, Dr. Kimball reported at the annual congress of the European Academy of Dermatology and Venereology.
During the 6-month study period psoriasis patients with comorbidities had an adjusted 2.3-fold greater hospitalization rate, made 1.6-fold greater use of the emergency department, and had 1.5-fold more outpatient visits.
Psoriasis patients with one or more comorbidities incurred an average $2,184 more in total health care costs during the study than patients free of comorbidities. But this figure varied widely depending on the specific comorbidity.
The disparity was greatest for psoriasis patients with comorbid cerebrovascular disease, whose total costs averaged $6,191 more than psoriasis patients with no comorbidities, according to Dr. Kimball of the department of dermatology at Harvard Medical School in Boston.
The study included 114,512 adult psoriasis patients in the Ingenix Impact National Managed Care Database for 1999-2004. A total of 50.9% of the study patients had one or more of the comorbid conditions that were of interest to the investigators.
The two most common comorbidities were hyperlipidemia and hypertension, each affecting about one-quarter of the psoriasis patients. Next was depression, with a 9.2% prevalence rating during the 6-month study period, followed by diabetes, at 8.7%. The diagnosis of psoriatic arthritis was present in the records of 5.1% of patients, she noted.
A diagnosis of cerebrovascular disease was carried by 3.1% of patients. Peripheral vascular disease and cardiovascular disease, the second and third most expensive comorbidities, with incremental costs of $5,381 and $5,280, respectively, were present in 2.8% and 8.6% of psoriasis patients. Individuals with comorbid cardiovascular disease had a hospitalization rate 4.2-fold greater than those without cardiovascular disease.
Interestingly, conventional wisdom holds that psoriasis patients are more overweight than the general population, but it was not confirmed in this study, as the prevalence of obesity was just 3.8%, said Dr. Kimball.
She is a consultant to Abbott, which funded the study.