Real world insights for psoriasis: the association of severity of skin lesions with work productivity, medical consumption costs and quality of life

Abstract

Background

Psoriasis is a prevalent, chronic skin disease with a potential impact on work productivity, medical consumption costs, and quality of life. The influence of the extent of skin lesions on these outcomes is not well known.

Objective

We determined associations of self-reported skin lesions with self-reported work productivity, medical consumption costs, and health-related quality of life in respondents with psoriasis.

Methods

In this cross-sectional study, we included respondents with self-reported psoriasis in the Netherlands in an online questionnaire. We assessed the self-reported percentage body surface area (BSA) of psoriasis lesions. We used validated instruments to assess work productivity (WPAI-PsO), medical consumption costs (iMCQ), and health-related quality of life (EQ-5D-5L and the DLQI). We used ordinal logistic regression to associate BSA categories >1% versus 0-1% with outcomes adjusted for multiple confounders.

Results

We included 501 respondents with a mean age of 43 ± 12 years; 64% were men. Median BSA was 2% (interquartile range 1–5%). A higher BSA was associated with higher overall work impairment due to psoriasis (common odds ratio [cOR] 2.44, 95% confidence interval [CI] 1.40–4.29; n = 205), higher medical consumption costs (cOR 2.06, 95% CI 1.45–2.94) and lower health-related quality of life. Associations were strongest with a BSA cutoff of 0% or 1% compared to 2% or higher categories.

Discussion

In our study, having few to no lesions in psoriasis was associated with lower overall work impairment due to psoriasis, lower medical consumption costs, and higher health-related quality of life.

Keywords:

• Dermatology
• epidemiology
• work productivity
• medical consumption cost
• questionnaire

Acknowledgements

The authors are grateful to all study respondents, and to ‘Psoriasispatiënten Nederland’ and the involved patients for testing and improving our questionnaire. Support from Dynata in collecting study data is gratefully acknowledged.

Disclosure statement

• TSL, RHB, KM, and HvB are employees of IQVIA, a human data science company, which received funds from Janssen-Cilag B.V. for the conduct of the study.

• EJGMC, LL, and AM are employees of Janssen-Cilag B.V.

• EMGJdJ has received research grants for the independent research fund of the department of dermatology of the Radboud university medical center Nijmegen, the Netherlands from AbbVie, BMS, Janssen Pharmaceutica, Leo Pharma, Lilly, Novartis, and UCB for research on psoriasis; has acted as consultant and/or paid speaker for and/or participated in research sponsored by companies that manufacture drugs used for the treatment of psoriasis or eczema including AbbVie, Boehringer-Ingelheim, Amgen, Almirall, Boehringer-Ingelheim, Celgene, Galapagos, Janssen Pharmaceutica, Lilly, Novartis, Leo Pharma, Sanofi and UCB. All funding is not personal but goes to EMGJdJ’s affiliated Institution.

What’s already known about this topic?

• Psoriasis is a prevalent, chronic skin disease with a potential impact on work productivity, medical consumption costs and quality of life.

• The extent of skin lesions is a central clinically useful indicator of disease severity, operationalized by total body surface area of a patient’s lesions (BSA).

• The association of BSA with work impairment and medical consumption cost is not well known.

What does this study add?

• We found associations for a higher extent of skin lesions with higher overall work impairment, higher medical consumption costs and lower health-related quality of life.

• Findings support the benefit of having BSA 0-1%, or ‘clear or near-clear’ skin, in psoriasis for the best patient reported outcomes

• We report medical consumption cost, and work productivity impairments for psoriasis patients in the Netherlands.

Additional information

Funding

This study is funded by Janssen-Cilag B.V.