Benefits and Costs of Biologics and Phototherapy in Psoriasis Treatment

How do biologics, phototherapy, and step-therapy strategies compare in efficacy, quality of life, and cost-effectiveness for psoriasis treatment?In this economic evaluation including a simulation of 500 000 patients with moderate to severe psoriasis, biologics yielded the largest average quality-of-life gains, step-therapy strategies provided similar benefits with less variability and lower system costs, and phototherapy remained cost-effective for payors, especially at home. Patients expressed the highest willingness to pay for biologics.Findings of this study suggest that aligning patient and payor incentives, such as reducing cost sharing for home phototherapy, may improve treatment access and health system sustainability.

Corresponding Author: Elizabeth A. Buzney, MD, Department of Dermatology, Brigham and Women’s Hospital, 221 Longwood Ave, Boston, MA 02115 (ebuzney@bwh.harvard.edu).

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