Computer modelling provides breakthrough in psoriasis management

23 September 2008

LEO Pharma has unveiled a new weapon in its long-running campaign to improve psoriasis management and treatment outcomes. However, the weapon is not a new drug but a ground-breaking computer-modelling tool, designed to help those involved in the assessment, planning and provision of psoriasis treatment in primary care to balance optimum outcomes with the growing need for cost control.

Psoriasis is an unpleasant, chronic skin disease, that can socially stigmatise patients who suffer from it. Close to 20 million adults in Europe and the United States are currently suffering from psoriasis and approximately 450,000 new cases of the serious skin disease are diagnosed each year. But despite the condition’s negative effect on patients’ quality of life, about half of patients with psoriasis are not under any clinical treatment.

Studies have shown how disruptive the condition can be for patients: 72% do not swim; 60% do not sunbathe; 64% do not wear clothes that would show bare arms and legs; 48% find that their sex life is affected. People with psoriasis are often stressed; see themselves as outcasts; feel physically restrained by their disease and have a greater tendency to depression and alcoholism (Ramsey B., O'Reagan M., British Journal of Dermatology 1988).

“Many people see psoriasis as just a skin problem which one will have to learn to live with. Therefore only half of all patients receive a satisfactory treatment today, even though their quality of life is clearly affected. This is not acceptable,” says Lars Olsen, Executive Vice President, R&D at LEO Pharma. “People with psoriasis can and should have a decent life. Drugs are on the market, they are safe and they work. This must be communicated so patients can come out into the open and get treated instead of hiding.”

Called Psoriasis and Me, the new computerised resource simulates the impact (over two years) of the use of a range of topical psoriasis therapies on patient outcomes and costs in a given primary care setting.

Co-developed in the UK by LEO Pharma and specialist health economics and outcomes research company Amygdala Ltd, Psoriasis and Me has been piloted with English service providers for the past 11 months and is already endorsed by the UK’s National Association of Primary Care (NAPC).

The pilot has not only revealed the extent to which providers in England are unaware of the sizeable sums being spent on psoriasis but also the very real prospect of significant savings that could run into millions of pounds if replicated across the UK.

“Health economics is an increasingly important factor in service redesign but it is often seen as a cold discipline that works against patient needs; ‘Psoriasis and Me’ demonstrates that this doesn’t have to be the case,” said Peter Jackson, Commercial Development Manager for LEO UK.

“The programme has already shown that as a result of more effective prescribing for psoriasis in an English primary care population of, say, 250,000, yearly savings could be as high as £277,000. If you extrapolate that to the UK population as a whole (c60million), the potential annual saving could be as much as £66million.”

The programme has also received extremely positive feedback from clinicians who have seen it in operation. Keith Freeman, a UK Consultant Dermatologist with dual responsibility for services in a primary care trust and a foundation hospital trust, sees the programme as a very welcome and valuable aid for local decision making.

“The priority for service commissioners in treating psoriasis is to achieve the best pathways of care — to make sure that the right patients are being treated in the right place at the right time for the best possible outcomes. Treating effectively in primary care is better for the patient and also means secondary care resources can be focused on the most appropriate cases. Tools like this are the way forward to help clinicians review services, optimise care and keep better control of costs.”

Psoriasis and Me works by comparing specific local data inputs — such as population size, waiting times for referrals to secondary care and the types and costs of treatments currently in use — to stored country-specific information and the Psoriasis Area and Severity Index (PASI 75). It then generates a report which calculates the optimum financial savings that could be made in a service redesign which would also improve patient outcomes using the most effective treatments.

“For decades, LEO Pharma has been at the forefront of challenging psoriasis,” said Kristian Hart-Hansen, LEO Pharma’s Manager of Corporate Pricing and Health Economics. “To date this has been with treatments but now that most countries insist on some form of health technology assessment (HTA) to demonstrate cost effectiveness; we want to add value to the process. The idea for Psoriasis and Me came from an HTA submission and, after the success of the UK pilot, its potential to reinforce our challenge to this life-affecting disease is very clear.”

Psoriasis and Me is now under development for use in a number of Northern European countries and LEO Pharma plans to roll out the programme over the next two years.

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