Out-of-Pocket Expenses in Patients with Psoriasis: A Study from a Tertiary Care Hospital in North India

BACKGROUND: Chronic inflammatory skin diseases, like psoriasis, have a significant financial burden on patients. Developing countries could have a more severe impact due to low per capita income and low penetration of health insurance. AIM AND OBJECTIVES: To evaluate the out-of-pocket (OOP) expenses of psoriasis patients and compare them between mild-moderate cases and severe cases. PATIENTS AND METHODS: The study involved psoriasis patients who were categorized into two groups based on the disease severity. The OOP expenses were calculated for the past four weeks. Inpatient versus outpatient management costs were also compared. RESULTS: The mean monthly OOP expenditure on treatment was significantly higher for the severe disease group [₹7087 ± 9021 ($85.45 ± 108.77/€78.09 ± 99.40)] than for the mild-moderate group [₹1871 ± 2138 ($22.56 ± 25.78/€20.61 ± 23.55) ( P = 0.001)]. In the severe disease group, OOP expenditure was notably higher than the mild-moderate group, primarily for medicines [₹4622 ± 7134 ($55.73 ± 86.02/€50.93 ± 78.61) vs ₹657.7 ± 534.9 ($7.93 ± 6.45/€7.24 ± 5.89) ( P = 0.001)] and diagnostics [₹1235 ± 1492 ($14.89 ± 17.99/€13.60 ± 16.44) vs ₹479.8 ± 335.0 ($5.78 ± 4.04/€5.28 ± 3.69) ( P = 0.001)]. The healthcare expenses incurred by inpatients were significantly higher than those of outpatients in the categories of medicines, diagnostics, and dietary provisions. Furthermore, it was observed that 76% of patients with psoriasis in the severe illness category and 13% in the mild-moderate group experienced catastrophic health expenditure. LIMITATIONS: The study underestimated costs by excluding comorbidities, productivity loss, indirect expenses, quality of life (QoL), private healthcare costs, and inflation adjustments. CONCLUSION: Patients with severe psoriasis experienced higher OOP expenses and catastrophic health expenditure. Financial aid from health agencies and the government could reduce costs and improve their QoL.