Psoriatic arthritis: pharmacoeconomic considerations.

Tumor necrosis factor (TNF) antagonists provide a clinically and economically efficient treatment option for psoriatic arthritis (PsA). PsA is a chronic inflammatory disease affecting the musculoskeletal system that, if untreated, can be disabling due to the progressive joint damage and the considerable impact on functional status and health-related quality of life. Therapies for PsA have been disappointing until recently. Traditional disease-modifying drugs are used to control symptoms, but there is no evidence that they slow the progression of the damage in peripheral joints. The introduction of the TNF-alpha-blocking agents has revolutionized the therapeutic management of PsA. These drugs lessen symptoms and signs of inflammation, enhance quality of life and functional capacity, and hinder the evolution of structural joint damage. TNF-alpha blockers are very expensive and not easily available to all patients, either depending on a national system or private insurance. Nevertheless, recent pharmacoeconomic studies have demonstrated that TNF-alpha blockers are cost-effective treatment options for the musculoskeletal and cutaneous manifestations of psoriatic disease.