When governments discuss strategies for noncommunicable diseases (NCDs), psoriasis and psoriatic arthritis are almost never mentioned. Our recent research says that this omission has cost the world’s economies billions.
Why do we need to include these diseases in the equation?
Psoriatic disease is a chronic inflammatory disease that includes psoriasis (affecting the skin) and psoriatic arthritis (affecting the joints). People with psoriatic disease are also more likely to develop other serious health problems, comorbidities, such as cardiovascular disease, type 2 diabetes, obesity, depression, and anxiety.
Ignoring the connections between psoriatic disease and serious comorbidities does not make them disappear. It simply shifts the cost — from prevention and early intervention to lifelong complications and tomorrow’s economic losses. Sooner or later, the price will be paid by society, in the form of more hospital admissions, more prescriptions, longer sick leave, time away from work and lost productivity, and consequently, lost quality and length of lives for many people affected.
For over 50 years, IFPA (the International Federation of Psoriasis Associations) has advocated for people living with psoriatic disease worldwide. We have long known that the burden of this disease extends far beyond the skin and joint symptoms. In our recent study, we put a price tag on that hidden burden by estimating the cost of major comorbidities linked to psoriasis and psoriatic arthritis: cardiovascular disease, type 2 diabetes, obesity, depression, and anxiety. We analysed data from three very different healthcare systems: the US, Denmark, and Vietnam. The conclusion was the same in all three: failing to prevent these conditions costs societies billions.
Over a lifetime, these comorbidities linked to psoriatic disease generate an estimated US$441.1 billion in healthcare and productivity costs in the US alone, $5.6 billion in Denmark and $2.1 billion in Vietnam.
To put these figures into perspective, in the US $441.1 billion is roughly one-third of the country's annual Medicare spending. In Denmark, $5.6 billion accounts for 13% of annual healthcare spending. In Vietnam, $2.1 billion represents roughly 9% of annual health spending.
But the real question policymakers should ask is: what do we lose by failing to prevent these comorbidities? Our research suggests that early systemic treatment could prevent a substantial share of the economic burden, potentially offsetting around one-third to nearly one-half of these costs.
The economic burden is only part of the story. The human burden is harder to measure, but it is carried everyday by more than 100 million people living with the disease worldwide. Over 80% of them experience stigma and discrimination. One-third say they have been blocked from work or study opportunities due to their condition. The burden carried by families is substantial: over 90% of family members report that the disease negatively affects their own wellbeing. These costs rarely appear in national health accounts but are paid every day by millions around the world.
Yet our global community demonstrates every day that change is possible. In Taiwan, patient advocates managed to reverse legislation that threatened access to treatment for more than 3,000 people. In Ghana, patient organisations collaborate with schools to educate children about psoriasis, reduce stigma, and prevent bullying.
These examples show the power of patient advocacy. But lasting progress requires patient organisations and governments working hand in hand.
In 2014, WHO Member States adopted the Resolution on Psoriasis, recognising it as a serious chronic NCD and calling for earlier diagnosis, access to treatment, stronger research, and a people-centred approach to care.
In 2015, all UN Member States adopted the Sustainable Development Goals and committed to achieve Universal Health Coverage by 2030. For people living with psoriasis these are not abstract promises. Patient organisations are working every day to make these commitments a reality. Now governments must do the same.
The question is no longer whether we can afford to invest in psoriatic disease care. The real question is: can we really afford to keep ignoring it?
The existing evidence simply says no.
