Cost-Utility Analyses of Systemic Treatments for Psoriasis and Psoriatic Arthritis in the UK: A Systematic Review of Modelling Methods
摘要
Psoriasis is a chronic inflammatory skin condition with a significant cost burden on the UK National Health Service (NHS). The objective of this systematic review is to describe and analyse the methods used in UK-based cost-utility analyses of systemic treatments for psoriasis and psoriatic arthritis.
MethodsWe registered the review protocol on PROSPERO (CRD420251179345). We searched Embase, MEDLINE, EconLit, NHS Economic Evaluations Database, and the websites of UK health technology assessment (HTA) organisations on 1 December 2025 with no language or date restrictions. We also checked the reference lists of previous systematic reviews for additional studies. The review included journal publications and HTA submission documents that reported cost-utility models evaluating systemic treatments for psoriasis or psoriatic arthritis in a UK setting. We conducted a narrative synthesis of modelling methods using all sources of information for each model. We evaluated model quality using the Drummond checklist.
ResultsSearches identified 659 unique, potentially relevant records (databases, n = 582; reference lists, n = 13; HTA websites, n = 64). After screening, we included 68 reports detailing 35 cost-utility analyses (psoriasis, n = 18; psoriatic arthritis, n = 17). Most followed a similar cohort-level model structure with induction and maintenance phases, but approaches to modelling treatment sequences varied and may not reflect clinical practice. Most psoriatic arthritis models accounted for both skin and joint symptoms, but psoriasis models only considered skin symptoms, and neither group directly modelled the impact of other comorbidities. Additional research would be beneficial to better inform parameters for efficacy in sequences of treatment and disease-related costs. The review was limited by incomplete reporting for some models.
ConclusionsModel structures in psoriasis cost-utility analyses are well-established, but future work should address limitations in approaches to treatment sequencing and comorbidities by better leveraging real-world evidence.