The social value of a PASI 90 or PASI 100 response in patients with moderate-to-severe plaque psoriasis in Spain

• Main Authors: Paulina Maravilla-Herrera (Author), María Merino (Author), Santiago Alfonso Zamora (Author), Jesús Balea Filgueiras (Author), José Manuel Carrascosa Carrillo (Author), Olga Delgado Sánchez (Author), Francisco Dolz Sinisterra (Author), Antonio García-Ruiz (Author), Pedro Herranz Pinto (Author), Antonio Manfredi (Author), José Martínez Olmos (Author), Paloma Morales de los Ríos Luna (Author), Lluís Puig (Author), Sandra Ros (Author), Álvaro Hidalgo-Vega (Author)
• Format: Book
• Published: Frontiers Media S.A., 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2565; 10.3389/fpubh.2023.1000776
• Keywords: social return; socioeconomic impact; psoriasis; Psoriasis Area and Severity Index (PASI); quality of life; out-of-pocket (OOP) expenses; Public aspects of medicine; RA1-1270
• Source: Frontiers in Public Health, Vol 11 (2023)

IntroductionPsoriasis is a chronic disease involving the skin, which significantly impacts the quality of life. Disease severity and treatment efficacy (i.e., response) are assessed through the Psoriasis Area and Severity Index (PASI). A PASI 75 response, i.e., an improvement of at least 75% with respect to the baseline PASI score, has traditionally been used as a therapeutic benchmark in clinical trials. Therapeutic advances have made PASI 90 or PASI 100 responses possible in most patients treated with some biologics. A greater response may generate social value beyond clinical outcomes that would benefit both patients and society.MethodsA 1-year economic model was applied to estimate the impact of having a PASI 75, PASI 90, or PASI 100 response in four areas of analysis (quality of life, activities of daily living, work productivity, and out-of-pocket expenditures) and the social value of having a PASI 90 or PASI 100 response in comparison with a PASI 75 response. A mixed-methods approach based on the scientific literature, a focus group with patient, and an advisory committee with psoriasis stakeholders was used. The model included three different scenarios: having a PASI 90 vs a PASI 75 response; a PASI 100 vs a PASI 90 response; and a PASI 100 vs a PASI 75 response. A sensitivity analysis was included.ResultsThe annual economic impact per patient with moderate-to-severe plaque psoriasis having a PASI 75 response was estimated at Ł 6,139, mainly related to labour productivity losses and quality of life reductions. Having a PASI 90 or a PASI 100 response would reduce this impact to €3,956 or €1,353, respectively. Accordingly, the social value of having a PASI 90 instead of a PASI 75 response was estimated at €2,183, and €4,786 with a PASI 100 response.DiscussionA PASI 90 or PASI 100 response would have a lower economic impact and a greater social value than a PASI 75 response for patients with moderate-to-severe plaque psoriasis.