The Hidden Costs of Psoriasis: A Population-Based Study Evaluating How Psoriasis Severity Impacts Work Absenteeism

August 2024 | Volume 23 | Issue 8 | 640 | Copyright © August 2024


Published online July 18, 2024

Kathryn Lee BAa, Paige Kingston BSb, Margaret Y. Huang BSb, Danielle Yee MDc, Hannah Peterson BSd, Edwin Korouri BSe, Rosario Agüero MDb, April Armstrong MD MPHc

aSaint Louis University School of Medicine, St. Louis, MO
bDepartment of Dermatology, Keck School of Medicine of USC, Los Angeles, CA
cDivision of Dermatology, Department of Medicine, David Geffen School of Medicine,
University of California Los Angeles, Los Angeles, CA
dLoma Linda University School of Medicine, Loma Linda, CA
eRosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, IL

Abstract
Background: Psoriasis patients experience physical and emotional burdens, which may lead to work-related productivity loss. This loss carries professional and financial repercussions. It is unknown whether the extent of psoriasis affects work absenteeism.
Objective: This study aims to compare work absenteeism between employed adults with mild versus moderate-to-severe psoriasis.
Methods: A national, cross-sectional study using the 2009 to 2019 Medical Expenditure Panel Survey evaluated 5,209,956 (weighted) adults aged ≥ 22 years. Work absenteeism was compared between adults with mild (4,521,687 weighted) and moderate-to-severe psoriasis (688,269 weighted).
Results: Work absenteeism, as measured by the average number of episodes per year that someone was absent from work for at least a half day, was significantly higher in patients with moderate-to-severe psoriasis than in patients with mild disease (4.4 episodes vs 2.8 episodes, P=0.002). Multivariable logistic regression models showed moderate-to-severe patients were 2.68 times more likely (95% CI:1.72-4.21; P<0.001) to take a half-day or more off from work than those with mild disease after adjusting for age, sex, race, ethnicity, poverty, cognitive limitations, insurance, education, and comorbidities.
Conclusion: Disease severity directly impacts work absenteeism in psoriasis patients. Early diagnosis and treatment with appropriate therapies are needed to reduce disease severity and limit economic loss and professional ramifications associated with psoriasis.

J Drugs Dermatol. 2024;23(8):640-644.  doi:10.36849/JDD.7550

INTRODUCTION

Psoriasis is a chronic inflammatory skin disease that affects nearly 8 million adults in the United States (US).1 The disease is characterized by sharply demarcated, scaly, erythematous plaques that can involve a large percentage of one’s body surface area.2-3 In addition to disease symptoms like pruritus, pain, and bleeding, associated medical comorbidities, such as cardiometabolic diseases and psoriatic arthritis, contribute to the high burden of disease among patients.2,4 Psoriasis can also have a profound impact on patients' mental health. Psoriasis patients are at increased risk of low self-esteem, depression, anxiety, self-harm, stress, and suicidality.5-7

The physical and emotional disease burden contributes to a reduced quality of life (QoL) and impaired function in psoriasis patients.8 This loss in productivity carries professional and financial repercussions. The estimated total annual economic burden of psoriasis in the US is 112 billion dollars.9 Up to 40% of the total costs of psoriasis are thought to be the result of decreased productivity and work loss.10 One component of work loss is work absenteeism, which is defined as missing work due to illness or disability.11 It has been found that adult psoriasis patients in the US miss approximately 1.26% more days of work than patients without psoriasis.12-13

While few studies examined work absenteeism between patients with and without psoriasis, little is known regarding how work absenteeism may differ between psoriasis patients with mild versus moderate-to-severe disease in the US This study aims to compare work absenteeism between employed adults with mild and moderate-to-severe psoriasis in the US.
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