What drives patient cost variability in psoriasis care: a single centre study

Area of Science:

• Dermatology and Health Economics
• Healthcare Management and Policy

Background:

• Psoriasis, a chronic inflammatory skin disease, imposes a significant economic burden on global healthcare systems.
• This study focuses on the provider's perspective of psoriasis consultations to generate cost data for value-based care.
• It aims to identify cost variability drivers, explore efficiency opportunities, and estimate annual treatment expenses.

Purpose of the Study:

• To analyze consultation-level cost drivers in psoriasis care.
• To estimate one-year treatment costs for psoriasis patients.
• To inform the development of bundled payment models and promote cost transparency.

Main Methods:

• Time-Driven Activity-Based Costing (TD-ABC) was employed to measure costs for 127 mild-to-moderate psoriasis patients.
• Data included nurse and physician time, patient status, therapy type, and comorbidities.
• Descriptive analyses were used to assess mean costs and variability.

Main Results:

• Mean consultation costs averaged €55, with new patients costing 40% more than returning patients.
• Key cost drivers included patient status, therapy switches, nurse experience, and physician consultation factors.
• Annual treatment costs ranged from €325 for topicals to €11,920 for biologics.

Conclusions:

• Substantial variability exists in psoriasis consultation and annual treatment costs.
• Detailed cost data is crucial for optimizing workflows, resource allocation, and designing payment models.
• Improving cost transparency enhances clinical and financial decision-making for chronic disease management.