Cost-Effectiveness of Treatments for Moderate-to-Severe Psoriasis at Chonburi Hospital

Abstract

Background: Psoriasis is a chronic inflammatory skin disease that significantly impairs quality of life and imposes a substantial economic burden. Various treatment modalities are currently available; however, real-world cost-effectiveness data from Thai public hospitals remain limited. This study aimed to compare the monthly cost and cost-effectiveness of conventional systemic therapy, phototherapy and biologic therapy for moderate-to-severe psoriasis.

Methods: This retrospective descriptive study was conducted among patients with moderate-to-severe psoriasis treated between October 2024 and October 2025. Pateints were categorized into three treatment groups: conventional therapy ,phototherapy  and biologic therapy. Data on medication costs, topical medication costs, laboratory monitoring costs, and total monthly expenditures were analysed and compared with treatment effectiveness

Results: The biologic group demonstrated the lowest median PASI score (2.9) and the highest effectiveness rate (100%), but also the highest median total monthly cost (13,918.5 THB/month). This group incurred the lowest topical medication costs (median 994.5 THB/month). Conventional systemic therapy had the lowest total monthly cost (4,583 THB/month) and the greatest overall cost-effectiveness (7,892.8 THB per responder). However, among conventional systemic agents, cyclosporine showed a cost per responder closer to biologic therapy than to other oral treatments. No patients in the phototherapy group achieved the effectiveness criteria during the study period.

Conclusion: Biologic therapy provides the highest clinical effectiveness but required substantially higher costs, whereas conventional systemic therapy remains the most cost-effective option overall. Notably, cyclosporine demonstrated a cost per responder closer to biologic therapy, indicating that its use may warrant careful consideration, particularly for long-term treatment.

Keywords: Psoriasis, Cost-effectiveness, Conventional systemic therapy, Biologic therapy, Phototherapy