Background/Purpose: Psoriatic arthritis (PsA), a chronic inflammatory joint disorder typically affecting individuals with psoriasis of the skin, is associated with severe comorbidities, reduced quality of life, and increased work disability. Our study is the first to comprehensively examine PsA’s comorbidties, healthcare and public transfer (allowance) costs.  

Methods: A total of 10,525 PsA patients and 20,777 matched general population comparator (GPC) subjects were included in this nationwide cohort study, using data from Danish registries from January 1998 through December 2014. Societal costs, employment status, and occurrence of comorbidities in patients with PsA both before and after diagnosis were compared to GPC subjects matched on age, sex, time, and marital status.  

Results: Median age of PsA patients and general population comparator subjects at study entry was 52 years (interquartile range 40 to 60 years), 41% were male. At baseline, PsA patients had significantly more comorbidities, including neoplasms (OR 1.25 95% CI 1.11 to 1.41), cardiovascular disease (OR 1.70 95% CI 1.55 to 1.86), respiratory diseases (OR 1.73 95% CI 1.54 to 1.96), infectious diseases (OR 2.03 95% CI 1.69 to 2.42), and haematological diseases (OR 1.94 95% CI 1.55 to 2.43) compared to GPC subjects. At all time-points, PsA patients had higher total healthcare costs (Figure) and public transfer costs; they also had lower income (p<0.001) and incurred a net average increased societal cost of 12,024 USD per patient year compared to GPC subjects following diagnosis. The relative risk (RR) for being on disability pension five years prior to PsA diagnosis was 1.36 (95% CI 1.24 to 1.49) compared to GPC subjects. The RR increased to 1.60 (95% CI 1.49 to 1.72) at the time of diagnosis and was 2.69 (95% CI 2.40 to 3.02) 10 years after diagnosis, where 21.8% of the PsA patients received disability pension.  

Conclusion: The study not only demonstrates increased healthcare costs, lower income, higher unemployment rates, higher risk for disability pension, but also  more comorbidities for PsA patients compared to the general population in the period prior to diagnosis. The study also clearly demonstrates attenuated socioeconomic burden as well as increased comorbidities in the years following a PsA diagnosis.   Figure