How much does psoriasis cost?
A recent article reported on a study in the Journal of the American Association of Dermatology (JAAD). It examined the cost-effectiveness of approved systemic treatments. You can’t see the complete study without a login, but the abstract gives you a snippet.
To standardize the results, the researchers calculated the cost of medication to reach a 75-percent reduction in psoriasis severity. Methotrexate and cyclosporine cost the least, at around $1,000 per month. On the costlier side, Remicade (infliximab) and Stelara (ustekinuma) cost the most, at around $10,000 per month.
The cost of treating psoriasis only goes up from there. I take two systemic medications that together cost more than $10,000 per month. Without health insurance I couldn’t come close to paying out of pocket for them. The financial expenditure on psoriasis-related products goes up even higher when you include the price of topical treatments or over-the-counter items such as expensive moisturizers.
As I read the JAAD article, I thought about what the true cost of psoriasis is. It’s not easy to quantify. I incur non-financial costs each day that I live with severe psoriasis. Here are a few of the most significant:
1. Social and Relational Costs
As a teenager and young adult, I felt lonely, awkward, and disconnected. Teased since early elementary school, I focused on achieving in school and sports. But I never felt like I belonged. Bullies targeted me throughout my childhood.
Now, I get mildly embarrassed when scalp psoriasis flakes fall on a dark suit. I may be reluctant to shake a person’s hand when my hand is covered in plaques or nail psoriasis. Others may not think twice about wearing shorts or swimming in a pool, but those with active psoriasis often do. Dating can become difficult, as can sex. The social and relational costs mount as self-esteem takes a hit with each “what is that” question.
2. Emotional Costs
The National Psoriasis Foundation (NPF) issued a brief on psoriasis and mental health. The summary states, “People with psoriasis experience higher rates of depression and anxiety, and people with severe psoriasis die, on average, four years younger than people without the disease. “
The report also stated this: “Patients with psoriasis have a 39 percent increased risk of depression, a 31 percent increased risk of anxiety and a 44 percent increased risk of suicidality. Patients with severe psoriasis have a 72 percent increased risk of depression.”
I shared my struggle with depression-related psoriasis in an earlier post. You can find more of my thoughts and helpful tips in 11 Ways to Fight Depression When You Have Psoriasis. Without a doubt, psoriasis has cost me emotionally.
3. Quality of Life and Longevity Costs
I can remember countless times when people told me that psoriasis wouldn’t kill me. While psoriasis is not a terminal disease, apparently it can reduce life expectancy. The NPF report I cited earlier says four years on average. What would I pay to get back those four or more years?
Of course, no one knows how long he or she will live. But if I might have a shorter life span, I would like to enjoy the time I do have. An abstract from a Dove Press journal article Quality of life issues and measurement in patients with psoriasis reports what many psoriasis patients already know: “The impact of psoriasis on patients’ overall quality of life is significant, broad, and deep, including effects on emotional wellbeing, psychological stress, self-esteem, relationship, work, social activities, financial burden, and even physical function.”
Psoriasis runs deeper than the skin when it comes to quality of life.
4. Lost Time and Opportunity
I learned a simple concept in economics class called “opportunity cost.” It’s simply giving up one opportunity by choosing something. In my case, I feel like psoriasis made the choice for me. I hate that I lose time caring for psoriasis (doctor visits, lab tests, treatment routines, etc.) when I would rather be doing a thousand other things. I lament when I don’t feel I should travel, take on a project, or eat certain foods out of fear I might bring about greater stress and inflammation on my skin. I’m not as productive when my skin’s on fire.
Time is limited. Opportunities pass. I can never get them back.
Clearly, psoriasis costs more than prescription treatments. What has psoriasis cost you?