Value in Psoriasis Care: From Patients to Payers

This symposium took place on 25th April 2016 as part of the Psoriasis Excellence Program for European Dermatologists in Hamburg, Germany, in collaboration with the Universitatsklinikum Hamburg-Eppendorf, the Hamburg Center for Health Economics, and the Regionale Psoriasisnetze in Deutschland

Chairpersons: Matthias Augustin,1 Marc Radtke1
Speakers: Matthias Augustin,1 Marc Radtke,1 Diamant Thaci,2 Kristian Reich,3 Ulrich Mrowietz4

1. Institute for Health Care Research in Dermatology and Nursing,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2. Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
3. Dermatologikum, Hamburg; Department of Dermatology, Georg-August University, Göttingen, Germany
4. Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany

Disclosure: Prof Augustin has served as a consultant and/or paid speaker for clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis, including AbbVie, Almirall, Amgen, Biogen, Boehringer Ingelheim, Celgene, Centocor, Eli Lilly, GSK, Janssen-Cilag, Leo, Medac, Merck, MSD, Novartis, Pfizer, UCB, and Xenoport. Prof Radtke has provided services relating to clinical trials, research relating to quality of life and health services in dermatology, advisory boards, conferences, and scientific presentations sponsored by Abbott, AbbVie, Almirall, Pfizer, MSD, Merck, Janssen, Biogen Idec, Leo Pharma, Basilea, Centocor, Celgene, Merck-Serono, Stiefel, Hexal, Moelnlycke Healthcare, Johnson & Johnson, Novartis, Lilly, Sandoz, Parexel, Medac, La Roche Posay, and Galderma. Prof Thaci has provided services and/or received honoraria related to clinical trials, consultancy, and Scientific Advisory boards sponsored by AbbVie, Almiral, Amgen, Astellas, Biogen Idec, Boehringer Ingelheim, Celgene, Dignity, Elli Lilly, Forward-Pharma, Galapagos, GSK, Leo, Janssen-Cilag, Maruho, MSD, Mitsubishi Pharma, Mundipharma, Novartis, Pfizer, Roche, Roche-Possay, Sandoz, and Xenoport. Prof Reich has served as advisor and/or paid speaker for and/or participated in clinical trials sponsored by AbbVie, Amgen, Boehringer Ingelheim, Celgene, Centocor, Covagen, Forward Pharma, GSK, Janssen-Cilag, Leo, Lilly, Medac, MSD, Novartis, Ocean Pharma, Pfizer, Regeneron, Takeda, UCB Pharma, and Xenoport. Prof Mrowietz has been an advisor and/or received speaker’s honoraria and/or received grants and/or participated in clinical trials sponsored by Abbott/AbbVie, Almirall-Hermal, Amgen, BASF, Biogen Idec, Boehringer Ingelheim, Celgene, Centocor, Eli Lilly, Foamix, Forward Pharma, Galderma, Janssen, Leo Pharma, Medac, MSD, Miltenyi Biotech, Novartis, Pfizer, Teva, VBL, Xenoport.
Acknowledgements: Writing assistance was provided by Dr Susan Mayor of Susan Mayor Limited.
Support: The meeting and publication of this article was funded by Celgene. The views and opinions expressed are those of the authors and not necessarily of Celgene.
Citation: EMJ Dermatol. 2016;4[1]:54-62.

Meeting Summary

The symposium explored new approaches to optimising the value of psoriasis management from the perspective of physicians, patients, and healthcare systems, drawing on research and evidence from real world clinical practice. The value in improving the management of psoriasis means boosting the efficacy of patient management, improving the power of outcomes measurement, raising the quality of care, and working more effectively with payers.

Many patients with moderate-to-severe psoriasis do not currently receive high quality care and are often undertreated, with many not receiving systemic therapy despite this being recommended by evidence based guidelines. Reasons for not initiating or maintaining systemic therapy included long-term safety concerns, convenience of use, and cost, even though psoriasis can result in irreversible cumulative life impairment.

The growing recognition that psoriasis is a systemic inflammatory disorder that is associated with a wide range of comorbidities, including obesity, cardiovascular disease, diabetes, hypertension, and depression, underlines the need for systematic evaluation and treatment of comorbidities and the use of systemic treatment. Setting and implementing treatment goals is considered essential for driving up the value of psoriasis care. These should include measures that matter most to patients, taking into account the impact of psoriasis on their quality of life, including involvement of visible areas and nails, pruritus, and recalcitrant plaques, in addition to objective measures such as their Psoriasis Area Severity Index (PASI) score. Comprehensive management of psoriasis should provide treatment or referral to relevant specialists working in an integrated way across a networked service.

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