Quantifying the Economic Impact of Psoriasis

Student thesis: Phd


Psoriasis affects around 3% of the UK population. Evidence of the economic impact of psoriasis in the UK remains limited. Understanding the economic impact of psoriasis can provide useful information for decision-makers to identify the economic losses and how they are spread across the different components of cost-of-illness and burden-of-disease. The overall aim of this thesis was to quantify the economic impact of psoriasis in the UK by addressing four main objectives: i) Identify, and if necessary develop, a descriptive framework defining a nomenclature system for the relevant components and methods when identifying and quantifying the economic impact of disease; ii) Identify and critically appraise published studies estimating cost-of-illness and burden-of-disease for people living with psoriasis; iii) Estimate health care costs attributable to psoriasis and identifying key drivers of NHS resources use in England; iv) Quantify the burden-of-disease due to psoriasis in the UK. A mixed-methods approach was used to address the set objectives. The traditional-pearl growing-based review and thematic framework analysis were used to develop and validate a descriptive framework defining a nomenclature system for cost-of-illness and burden-of-disease. Two systematic reviews were used to critically appraise published psoriasis cost-of-illness and burden-of-disease studies. A retrospective observational matched cohort study with regression-based analyses was used to estimate costs attributable to psoriasis. A survey-based study was used to quantify the burden-of-disease in a sample of the UK population. No pre-existing framework to appraise economic impact of disease studies was identified. A framework to appraise studies reporting the cost-of-illness and burden-of-disease of psoriasis was developed. A limited evidence base relevant to the UK setting reporting the economic impact of psoriasis was identified. The cohort study identified that the costs attributable to psoriasis were found to be substantial. Comorbidities and obesity were observed to be key drivers of health care resource use and costs. The burden-of-disease due to psoriasis was noted to significantly impact both health and beyond health aspects. These findings will contribute to influencing policy recommendations on the need to tackle obesity and comorbidity in people living with psoriasis in the UK to reduce health care resource use.
Date of Award1 Aug 2023
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorChristopher Griffiths (Supervisor), Katherine Payne (Supervisor), Darren Ashcroft (Supervisor) & Thomas Mason (Supervisor)


  • Skin conditions
  • Cost of illness
  • Dermatology
  • Economic analysis
  • Economic Impact
  • Economics
  • Psoriasis
  • Burden of disease

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