[Health economic aspects of psoriasis therapy. Is inpatient topical treatment of plaque-type psoriasis in this age of biologics still appropriate from both medical and economic viewpoints?].

BACKGROUND: We tried to clarify whether the treatment of plaque psoriasis as an inpatient with dithranol and narrow band UV-B 311 nm is still appropriate and economical when compared to biologics such as efalizumab. PATIENTS AND METHODS: In a 15 month period, all patients admitted to the hospital after unsuccessful outpatient treatment of psoriasis were evaluated prospectively according to medical and economical criteria.
RESULTS: PASI-score was reduced by 89% in 74 patients. The direct cost to improve one in-patient by 75% in PASI score (PASI-75) was 4342.27 EUR; the total costs for employed patients were 7441.81 EUR. Direct costs of treatment with efalizumab would come to 15048.89 EUR per patient with PASI-75 in a 12 weeks period.
CONCLUSION: Topical inpatient therapy for plaque psoriasis is well tolerated and a less expensive option than biologics in those who fail ambulatory treatment.