Estimation of direct and indirect costs of one year treatment for psoriasis outpatients in Iran: a study in Razi Hospital in 2017-2018

Psoriasis is a systemic and non-transmissible chronic inflammatory autoimmune skin disease that about 2-3% of Iranians suffer from it. Cost of management and budgeting and planning for the treatment of patients with psoriasis requires accurate information. The present study estimates the direct and indirect costs for one-year treatment of patients admitted in Razi Dermatology Hospital.

In this descriptive-analytical study, treatment costs of 170 patients with psoriasis, including direct (medical and non-medical) and indirect costs were evaluated by census method and using a researcher-made checklist, from October 2017 to October 2018. The fee was collected through reviewing patients' bills in the hospital information system and through telephone interviews with patients.

The average cost of one year was 9037480 Tomans ($ 758), of which direct cost of treatment was 90.22% (8178681 Tomans) and indirect cost of treatment was 9.78% (858799 Tomans). The highest cost of treatment was related to pharmaceutical services with 5825233 Tomans. Also, the total direct medical cost was equal to 7069890 Tomans, of which 62% was the insurance share and 38% was the patient share. The findings showed that injecting biological drugs and accommodation had a significant effect on the direct cost of treatment. Supplementary insurance and accommodation variables also affect out-of-pocket costs.

Drugs made up most of the costs. The high price of biologics and the low coverage of these drugs by insurance companies have caused many economic problems for these patients. According to the findings of this study, it seems necessary to review the more complete insurance coverage of these drugs as well as the use of charitable assistance to cover part of the cost for treatment.