Direct Cost Estimation of Psoriatic Arthritis Treatment In Turkey: Results From A Delphi Panel

The aim of the study is to estimate the annual direct disease cost for psoriatic arthritis (PsA) from the payer perspective (SSI) in Turkey. Delphi panel was organized for collecting data based on five clinicians’ experiences to calculate direct disease cost as per the cost-of-illness methodology. Unit costs for each source were calculated from the perspective of SSI on an annual basis based on country-specific 2016 reimbursement price list. Costs associated with comorbidities, complications and side effects were calculated based on Delphi panel data and included in the total cost in accordance with their prevalence rates. The mean annual cost of outpatient visit and laboratory/imaging tests has been found to be €176.6 per patient. The cost was calculated to be €77.4 for inpatient treatment and €91.1 for medical interventions such as joint replacement, stent, rehabilitation. NSAIDs are used in 95% of the patients as long as the patient gains benefit from these drugs. Steroids are used in 30% of the patients. Among disease-modifying antirheumatic drugs, methotrexate is used in 75% of the patients while sulfasalazine is used in 32%, leflunomide in 25%, cyclosporine in 10% and anti-malaria agents are used in 10%. 30% of the patients receive vitamin D treatment. Distribution of biologic treatments is as follows: 37% Adalimumab, 30% Etanercept, 13% Infliximab, 10% Golimumab, 7% Certolizumab and 3% Infliximab-biosimilar. The mean annual pharmaceutical cost is €2,154.08. The cost has been found to be €146.8 for side effects and complications while it was €512.9 for comorbid conditions. The mean annual disease cost of PsA is estimated to be €3158.9 per patient and the estimated economic burden of PsA for the public payer is €118,424.031. These results contribute to increase awareness on treatment patterns and associated costs of the disease in Turkey.