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Background There are limited data available on the economical burden of psoriasis and its impact on everyday life. Objective The aim of this study was to evaluate the impact of psoriasis on personal and professional life, and to evaluate the cost of psoriasis for the patient. Methods We performed a cross-sectional study in psoriasis patients. All patients aged ≥18 years with a diagnosis of plaque-psoriasis confirmed by a physician were included. A self-administered questionnaire evaluating everyday life was constructed with members of the French association of psoriasis patients. In addition, the Dermatology Life Quality Index (DLQI), Working Productivity and Activity Impairment and individual costs were assessed. Results A total of 590 patients completed the study. Mean age of the responders was 56 years. The mean DLQI score was 8.5 for patients with severe psoriasis vs. 6.4 for mild psoriasis. Global loss of productivity was 10.7% without significant difference according to the disease severity. Daily activities alteration was most important in patients with severe psoriasis. In this study, 36.8% of patients with severe psoriasis reported a negative impact on their professional life vs. 19.6% for patients with mild psoriasis ( P = 0.002). Time devoted to phototherapy was on average 33 h/year/patient and the application of emollients took 25 h/year/patient; 47.3% of patients had a feeling to clean the house more often, in correlation with the severity of the disease. Mean out-of-pocket expenses for the disease was estimated to be 543€/year/patient. High impact of psoriasis on quality of life (DLQI >10), age <40 years and joint involvement were significantly associated with an increased risk of loss of work productivity. Conclusion Psoriasis, particularly severe psoriasis, is a true burden for patients and impacts significantly everyday life and patient’s economical resources. [ABSTRACT FROM AUTHOR]

Lilliu H, Brun-Strang C, Le Pen C, Büchler M, Al Najjar A, Priol G, Reigneau O, Lebranchu Y. Cost-minimization study comparing Simulect® vs. Thymoglobulin® in renal transplant induction. Clin Transplant 2004: 18: 247–253. © Blackwell Munksgaard, 2004 Based on the data of clinical trial CHI-F-02 comparing the efficacy and safety of basiliximab (Simulect®) vs. anti-thymocyte globulin (Thymoglobulin®) in renal transplant induction, we carried out an economic evaluation. This pharmacoeconomic study was a cost-minimization study, i.e. given the equivalent efficacy of the products, the strategy that minimized the cost of care was considered better. The cost of care was analyzed from the hospital perspective. This ‘piggyback’ study of 100 patients estimated the direct medical costs incurred over 6 months of use of two strategies for renal transplant induction therapy. Direct medical costs are those of utilized medical resources: medications, hospital stays, dialysis, and physician visits and investigations not scheduled in the protocol. In the Simulect® arm, significant reductions were found in the initial hospital stay duration and number of infectious episodes. Therefore, although the average cost of treatment was slightly higher with Simulect® than with Thymoglobulin® (2964 vs. 2298 Euros), the cost of the initial hospitalization was significantly lower in the Simulect® arm (10 907 vs. 11 967 Euros; p = 0.02). Furthermore the mean cost of infectious episodes was significantly lower in the Simulect® arm (1056 vs. 1790 Euros, p = 0.03). Cytomegalovirus infection accounted for a significantly smaller proportion of this cost in the Simulect® arm than in the Thymoglobulin® arm (30% vs. 53%, p = 0.001). This study showed direct medical cost savings of 1159 Euros per patient in the Simulect® arm, which more than compensated for the higher price of this immunosuppressive drug. [ABSTRACT FROM AUTHOR]