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  • Presentation

Psoriasis: Improving Outcomes and Cost-Effective Care

Description

The talk focuses on the complex relationship between psoriasis, cardiovascular health, and cost-effective treatment strategies. Psoriasis is a prevalent chronic inflammatory condition that is often stigmatized and linked to increased cardiovascular risks, resulting in a shortened lifespan for patients. Various treatment modalities exist, including topicals, systemic agents, and biologics, with the treatment plan typically dependent on the severity of the disease. The speaker highlights the importance of aiming for complete clearance (PASI 90) of psoriasis to enhance patients' quality of life while pointing out the staggering cost associated with systemic drug utilization in treating the condition, amounting to $27 billion in 2023. There is a call for dermatologists to screen for cardiovascular risk factors, as psoriasis significantly correlates with higher incidences of heart disease, emphasizing a need for improved collaboration with primary care providers. The role of phototherapy as a cost-effective alternative is also underscored, showcasing its comparable efficacy to biologics but at a fraction of the cost. Furthermore, the speaker shares insights from an ongoing study advocating for home phototherapy's effectiveness compared to office treatments, thereby addressing barriers such as access and co-pay challenges for patients. Ultimately, the emphasis is on enhancing patient outcomes through better screening, education, and collaboration within the healthcare system, particularly for those at elevated cardiovascular risk.

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Conclusions

  • Psoriasis is a common and highly stigmatized chronic inflammatory disease that significantly reduces life expectancy due to increased cardiovascular risks.
  • Current treatment options include topical agents and systemic therapies, with the latter being necessary for moderate to severe cases.
  • Achieving a PASI 90 response leads to better health-related quality of life outcomes compared to PASI 75 responses.
  • Cost-effectiveness analysis shows that phototherapy is significantly cheaper than biological treatments and is comparably efficacious, with added safety benefits.
  • Home phototherapy has been shown to be non-inferior to office-based phototherapy in treating psoriasis, making it a viable first-line treatment option.
  • Despite improvements in treatment options, many patients with psoriasis remain under-screened and under-managed for cardiovascular risk factors.
  • Education about cardiovascular risks associated with psoriasis is essential for improving patient care and outcomes.
  • Systemic therapies for psoriasis, including certain biologics, may have exorbitant costs that challenge healthcare sustainability.
  • There is a need for interdisciplinary approaches, including collaboration with primary care providers and cardiologists, to effectively manage cardiovascular risk in psoriasis patients.
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