What is the cost of treating psoriasis?

Severity Levels of Psoriasis

Psoriasis is a chronic autoimmune condition that affects the skin, and its severity can vary significantly from person to person. Understanding the different severity levels is crucial for determining the appropriate treatment approach and associated costs.

Mild Psoriasis

Mild psoriasis is characterized by small, localized patches of red, scaly skin, typically covering less than 3% of the body surface area.

• Symptoms and risk factors: Small, red patches with silvery scales, often on elbows, knees, or scalp. Risk factors include stress, certain medications, and family history.
• Diagnosis: Often possible through self-diagnosis or virtual doctor consultation.
• Imaging/Labs: Usually not necessary for mild cases.
• Treatments: Primarily topical treatments such as corticosteroid creams and lifestyle changes like stress reduction and moisturizing routines.

Moderate Psoriasis

Moderate psoriasis involves larger patches of affected skin, covering 3-10% of the body surface area.

• Symptoms and risk factors: Larger, more numerous patches of red, scaly skin. May affect larger areas of the body, including torso and limbs. Risk factors similar to mild psoriasis, but with potentially greater impact.
• Diagnosis: Typically requires an in-person doctor visit for accurate assessment.
• Imaging/Labs: May include blood tests to rule out other conditions and potentially a skin biopsy for definitive diagnosis.
• Treatments: Combination of topical treatments, oral medications, and possibly phototherapy.

Severe Psoriasis

Severe psoriasis is characterized by extensive coverage of the body (more than 10% of the surface area) and intense symptoms that significantly impact quality of life.

• Symptoms and risk factors: Widespread, thick, red patches with heavy scaling. May affect large areas of the body, including hands, feet, and genitals. Increased risk of psoriatic arthritis and other comorbidities.
• Diagnosis: Requires an in-person visit with a dermatologist for comprehensive evaluation.
• Imaging/Labs: Comprehensive blood tests to assess overall health and potential comorbidities, skin biopsy for definitive diagnosis and to rule out other conditions.
• Treatments: Often involves systemic medications, biologics, and combination therapies to manage symptoms and prevent disease progression.

Summary Table: Severity Levels

Understanding these severity levels is crucial for patients and healthcare providers to determine the most appropriate and cost-effective treatment approach. The severity of psoriasis can fluctuate over time, so regular assessment and adjustment of treatment plans may be necessary.

Getting a Diagnosis

Getting an accurate diagnosis is the first step in treating psoriasis effectively. The method you choose can significantly impact both the cost and the timeline of your treatment. Here are the main options available, along with their associated costs and time considerations:

Self-diagnosis

While self-diagnosis can be tempting due to its immediacy and lack of cost, it's generally not recommended for psoriasis. Skin conditions can be difficult to distinguish without professional expertise. However, if you suspect you have mild psoriasis, you might start with this approach before seeking professional help.

• Cost: $0
• Time: Immediate
• Appropriate for: Initial assessment of very mild symptoms

Virtual doctor consultation

Virtual consultations have become increasingly popular, offering a convenient and often cost-effective way to get a preliminary diagnosis.

• Teladoc:
  • With insurance: $0-$119 per visit (depending on insurance coverage)
  • Without insurance: $89 for general medical visits, $99 for therapy visits
  • Time: Usually within 24 hours, often much quicker
• MDLive:
  • With insurance: As low as $0 (depending on coverage)
  • Without insurance: $82 for urgent care, $95 for dermatology consultation
  • Time: Usually same-day appointments available
• OptimalMD:
  • Cost: Free with OptimalMD membership ($47/month for the entire family)
  • Time: Same-day appointments often available
  • Additional benefits: Includes access to 800+ generic medications at no extra cost and heavily discounted labs, procedures, and imaging

Virtual consultations are appropriate for mild to moderate psoriasis cases and can be an excellent first step in getting a diagnosis.

In-person doctor visit

For more severe cases or when a physical examination is necessary, an in-person visit to a general practitioner might be required.

• Average US clinic:
  • With insurance: $20-$50 copay (depending on your plan)
  • Without insurance: $203 for a primary care visit, $300-$600 for a specialist
  • Time: 30-60 minutes for the appointment, may require scheduling in advance
• OptimalMD:
  • Cost: Heavily discounted with OptimalMD membership
  • Time: Usually quicker access to appointments than traditional clinics

In-person doctor visits are appropriate for all severity levels of psoriasis, especially moderate to severe cases.

Dermatologist visit

For complex or severe cases of psoriasis, a visit to a dermatologist might be necessary for accurate diagnosis and treatment planning.

• Average US dermatologist:
  • With insurance: Typically a specialist copay of $30-$50 (varies by insurance plan)
  • Without insurance: Average of $221 per visit
  • Time: 15-30 minutes for the appointment, may require waiting several weeks for an appointment
• OptimalMD:
  • Cost: Heavily discounted with OptimalMD membership
  • Time: Often quicker access to specialists compared to traditional routes

Dermatologist visits are most appropriate for moderate to severe psoriasis cases, or when other treatments haven't been effective.

Summary Table: Assessment Options

This table provides a quick overview of the diagnosis options, their appropriate use cases, costs, and efficiency. Remember that while cost and convenience are important factors, the most appropriate option for you will depend on the severity of your symptoms and the advice of healthcare professionals.

Imaging and Laboratory Tests

When diagnosing and monitoring psoriasis, various imaging and laboratory tests may be necessary. The type and frequency of these tests often depend on the severity of your condition and the treatments you're using. Let's explore the common tests, their costs, and efficiency.

Blood Tests

1. Complete Blood Count (CBC)

A CBC is often used to assess overall health and can help identify infections or other conditions that might affect psoriasis treatment.

• LabCorp: $29.00 (cash price)
• Quest Diagnostics: $29.00 (cash price)
• Hospital labs: $100-$200 (before insurance)
• With insurance: Usually covered, may have a copay of $10-$50
• Free with OptimalMD membership

Time: Results typically available in 1-3 business days.

2. Liver Function Tests

These tests are crucial, especially if you're taking certain psoriasis medications that can affect liver function.

• LabCorp: $36.00 - $113.99 (cash price, varies by location)
• Quest Diagnostics: $23.00 - $31.00 (cash price)
• Hospital labs: $100-$300 (before insurance)
• With insurance: Usually covered, may have a copay of $10-$50
• Free with OptimalMD membership

Time: Results typically available in 1-3 business days.

Skin Biopsy

A skin biopsy involves removing a small sample of skin for microscopic examination. It's usually performed to confirm a psoriasis diagnosis or rule out other conditions.

• Dermatologist office: $221 - $481 (cash price)
• With insurance: Copay typically $20-$40, plus additional costs for the procedure
• Medicare: Approximately $58.40 (patient responsibility may vary)
• Heavily discounted with OptimalMD membership

Time: The procedure itself takes about 15-30 minutes. Results are usually available in 3-5 business days.

Diagnostic Imaging

While less common for psoriasis, some cases may require imaging studies, particularly for psoriatic arthritis.

1. X-rays

• Imaging centers: $45 - $250 (cash price)
• Urgent care centers: $65 - $190 (cash price)
• Hospitals: $100 - $500+ (cash price)
• With insurance: Usually covered with copays ranging from $0 - $50
• Heavily discounted with OptimalMD membership

Time: The procedure takes 5-10 minutes, with results often available immediately or within 24 hours.

2. MRI (for severe cases or suspected psoriatic arthritis)

• Radiology centers: Starting from $250 (cash price)
• Hospitals: $1,000 - $5,000+ (before insurance)
• With insurance: Copays typically $50 - $500, depending on the plan
• Heavily discounted with OptimalMD membership

Time: The procedure takes 15-90 minutes, depending on the area being scanned. Results are usually available within 24-48 hours.

It's important to note that while OptimalMD offers significant savings on many tests and procedures, some specialized imaging like MRIs may still incur some costs. Always check with OptimalMD for the most up-to-date pricing information.

Summary Table: Diagnostics

Note: All tests are either free or heavily discounted with OptimalMD membership ($47/month for the entire family).

Prescription Medications

Prescription medications are a cornerstone of psoriasis treatment, especially for moderate to severe cases. The choice of medication depends on the severity of the condition, the patient's overall health, and the response to previous treatments. Let's explore the various options, their costs, and efficiency.

Topical treatments

1. Corticosteroids

Corticosteroids are often the first-line treatment for mild to moderate psoriasis. They work by reducing inflammation and slowing cell turnover.

• Clobetasol (generic):
  • Cash price: $21.99 - $203.05 (varies by form and quantity)
  • With insurance: Typically a copay of $10-$50, depending on your plan
  • Free with OptimalMD membership
  • Time: Apply 1-2 times daily for 2-4 weeks
• Temovate (brand name for clobetasol):
  • Cash price: $179 - $507.10 (varies by form and quantity)
  • With insurance: Typically a copay of $30-$75, depending on your plan
  • Heavily discounted with OptimalMD membership
  • Time: Apply 1-2 times daily for 2-4 weeks

2. Vitamin D analogues

Vitamin D analogues help slow skin cell growth and reduce inflammation.

• Calcipotriene (generic):
  • Cash price: $49.29 - $985.01 (varies by form and quantity)
  • With insurance: Typically a copay of $10-$50, depending on your plan
  • Free with OptimalMD membership
  • Time: Apply once daily for 6-8 weeks
• Dovonex (brand name for calcipotriene):
  • Cash price: Around $338 for 60 grams of cream
  • With insurance: Typically a copay of $30-$75, depending on your plan
  • Heavily discounted with OptimalMD membership
  • Time: Apply once daily for 6-8 weeks

Oral medications

For moderate to severe psoriasis, oral medications may be prescribed.

1. Methotrexate (generic):

• Cash price: $35 - $2,876.95 (varies by form and quantity)
• With insurance: Typically a copay of $5-$25, depending on your plan
• Free with OptimalMD membership
• Time: Weekly dose, effects seen in 4-6 weeks

2. Acitretin (brand name: Soriatane):

• Cash price: $102.99 - $447.99 (varies by dosage and quantity)
• With insurance: Typically a copay of $30-$75, depending on your plan
• Heavily discounted with OptimalMD membership
• Time: Daily dose, effects seen in 2-3 months

Biologics

For severe psoriasis or when other treatments have failed, biologics may be prescribed. These are typically more expensive but can be highly effective.

1. Adalimumab (brand name: Humira, biosimilars available):

• Cash price: $6,200 - $7,300 per month
• With insurance: Copay can vary widely, from $0 to several hundred dollars, depending on your plan
• Heavily discounted with OptimalMD membership
• Time: Injections every 1-2 weeks, effects seen in 4-12 weeks

2. Secukinumab (brand name: Cosentyx):

• Cash price: $7,811 - $8,193.51 per month
• With insurance: Copay can vary widely, from $0 to several hundred dollars, depending on your plan
• Heavily discounted with OptimalMD membership
• Time: Monthly injections, effects seen in 12-16 weeks

It's important to note that while biologics can be highly effective, they are also the most expensive treatment option for psoriasis. However, many pharmaceutical companies offer patient assistance programs that can significantly reduce out-of-pocket costs for eligible patients.

Summary Table: Prescription Medications

Note: All medications listed are available for free or heavily discounted with OptimalMD membership ($47/month for the entire family).

Over-the-Counter Treatments

Over-the-counter (OTC) treatments are often the first line of defense for managing mild to moderate psoriasis symptoms. These treatments are generally more affordable and accessible than prescription medications. Let's explore the various OTC options, their costs, and effectiveness.

Moisturizers

Moisturizers are essential for managing psoriasis, as they help reduce dryness, itching, and scaling. They're suitable for all severity levels but are particularly beneficial for mild cases.

Based on the information provided by our cost lookup tool, here are some examples of moisturizers and their prices:

• CeraVe Moisturizing Cream:
  • CVS: $19.99 for 1.89 ounces ($11.76 per ounce)
  • National average: Approximately $10-15 per 16 oz jar
• Cetaphil Moisturizing Cream:
  • Walgreens: $18.99 for 16 ounces ($1.19 per ounce)
  • National average: Approximately $10-20 per 16 oz jar

Prices may vary depending on location, sales, and promotions. Many drugstores offer loyalty programs or discount cards that can reduce these prices by 10-20%. Insurance typically doesn't cover OTC moisturizers, but some flexible spending accounts (FSAs) or health savings accounts (HSAs) may reimburse these expenses.

Time efficiency: Apply daily, taking about 5 minutes per application.

Coal tar products

Coal tar has been used for decades to treat psoriasis. It can help slow skin cell growth and reduce inflammation, scaling, and itching.

Here are some examples of coal tar products and their prices:

• MG217 Psoriasis Coal Tar Shampoo:
  • Amazon: $24.00 for 8 fl oz ($3.00 per oz)
  • National average: $20-30 per 8 fl oz bottle
• Neutrogena T/Gel Therapeutic Shampoo:
  • Walmart: $36.95 for 8.5 fl oz ($4.35 per oz)
  • National average: $15-25 per 8.5 fl oz bottle

As with moisturizers, prices can vary, and store loyalty programs or discount cards may offer savings. Insurance generally doesn't cover these OTC products, but some FSAs or HSAs might.

Time efficiency: Use as directed, typically 2-3 times per week. Each application takes about 5-10 minutes.

Salicylic acid preparations

Salicylic acid helps remove scales and can improve the appearance of psoriasis patches.

Examples of salicylic acid preparations and their prices:

• CeraVe Psoriasis Moisturizing Cream:
  • Target: $21.82 for 8 oz ($2.73 per oz)
  • National average: $20-25 per 8 oz tube
• Gold Bond Ultimate Psoriasis Relief Cream:
  • Amazon/Target: $11.99 for 4 oz ($3.00 per oz)
  • National average: $10-15 per 4 oz tube

As with other OTC products, these are typically not covered by insurance but may be eligible for FSA or HSA reimbursement. Store loyalty programs and discount cards may offer additional savings.

Time efficiency: Apply as directed, usually once or twice daily. Each application takes about 5 minutes.

Summary Table: OTCs

Note: Prices are approximate and can vary based on brand, location, and current promotions. While insurance typically doesn't cover OTC treatments, some FSA or HSA plans may reimburse these expenses. Always consult with a healthcare provider to determine the most appropriate treatment for your specific condition.

Procedures

Procedures can be an essential part of psoriasis treatment, particularly for moderate to severe cases. The two main types of procedures used in psoriasis treatment are phototherapy and laser therapy. Let's explore each of these options in detail, including their costs and efficiency.

Phototherapy

Phototherapy involves exposing the skin to controlled amounts of ultraviolet light. There are two main types of phototherapy used for psoriasis:

1. Narrowband UVB therapy

Narrowband UVB therapy is often the first-line phototherapy treatment for psoriasis. It's typically recommended for moderate to severe cases.

• National Average: $75 per session
• Typical treatment course: 2-3 sessions per week for 6-8 weeks
• Total cost for a full course: $900 - $1,800

Here are some examples of providers and their prices:

• Mayo Clinic (Rochester, MN): Prices vary. Contact Patient Estimating Service at 833-479-5483 for a cost estimate.
• University of Michigan Health (Ann Arbor, MI): Specific pricing not available. Annual costs can range from $314 to $7,582 per patient.
• NYU Langone Health (New York, NY): Specific pricing not available. In-office phototherapy for psoriasis can cost around $3,900 per year on average.

Insurance coverage for phototherapy can vary. Many insurance plans cover phototherapy, but patients may be responsible for copayments or coinsurance. Typically, patients might expect to pay 10-20% of the total cost after meeting their deductible. Always check with your insurance provider for specific coverage details.

2. PUVA (Psoralen + UVA)

PUVA therapy combines UVA light exposure with a light-sensitizing medication called psoralen. It's often used for more severe cases of psoriasis or when other treatments haven't been effective.

• National Average: Approximately $3,083 per year (including induction and maintenance)
• Typical treatment course: 2-3 sessions per week for 12-16 weeks, followed by maintenance sessions
• Cost per session (estimated): $100 - $150

Examples of providers and their prices:

• Cleveland Clinic (Cleveland, OH): Specific PUVA pricing not available. General phototherapy sessions can cost around $65 each, with a full regimen costing $1,300 to $2,340.
• Massachusetts General Hospital (Boston, MA): Contact Patient Financial Experience Team at 617-726-3884, option 2, for pricing information.

Insurance coverage for PUVA therapy is similar to that of Narrowband UVB therapy. Many insurance plans cover it, but patients may be responsible for copayments or coinsurance. As always, it's crucial to check with your insurance provider for specific coverage details.

Laser Therapy

Laser therapy, specifically excimer laser therapy, is another option for treating psoriasis. It's often used for localized areas of psoriasis and can be particularly effective for scalp psoriasis.

• National Average: $100 - $200 per session
• Typical treatment course: 2-3 sessions per week for 4-6 weeks
• Total cost for a full course: $800 - $3,600

Examples of providers and their prices:

• Mount Sinai Hospital (New York, NY): Pricing varies. Most health insurance and Medicare plans cover the treatment costs of XTRAC laser therapy for psoriasis.
• Stanford Health Care (Stanford, CA): $100 - $150 per session.

Insurance coverage for excimer laser therapy can vary. Many insurance plans cover it when it's deemed medically necessary, but patients may be responsible for copayments or coinsurance. Some plans may require pre-authorization. As always, it's important to check with your insurance provider for specific coverage details.

Summary Table: Procedures

*Insurance coverage can vary significantly. Always check with your provider for specific details.

It's important to note that the effectiveness and appropriateness of each treatment can vary depending on the individual case. Always consult with a dermatologist to determine the best treatment plan for your specific situation.

Optimizing for Cost

When optimizing for cost in psoriasis treatment, it's important to consider the severity of the condition and balance effectiveness with affordability. Here are cost-effective strategies for each severity level:

Mild Psoriasis

• Self-diagnosis or virtual consultation to minimize initial costs
• Over-the-counter moisturizers and coal tar products as first-line treatments
• Generic topical corticosteroids if prescribed
• Lifestyle modifications (stress reduction, dietary changes) at no additional cost

Moderate Psoriasis

• In-person doctor visit for accurate diagnosis
• Generic oral medications like methotrexate if topical treatments are insufficient
• Combination of prescription and over-the-counter treatments to reduce overall medication costs
• Consider phototherapy as a cost-effective alternative to long-term medication use

Severe Psoriasis

• Dermatologist consultation for specialized care
• Explore patient assistance programs for high-cost biologics
• Consider biosimilars when available as a more affordable alternative to brand-name biologics
• Combine treatments (e.g., phototherapy with systemic medications) to potentially reduce the required dose of expensive medications

General Cost-Saving Strategies

• Use generic medications whenever possible
• Take advantage of prescription discount programs and coupons
• Maintain consistent treatment to prevent flare-ups and reduce long-term costs
• Regularly review and adjust treatment plan with healthcare provider to ensure cost-effectiveness

By implementing these strategies, patients can work towards managing their psoriasis effectively while minimizing out-of-pocket expenses. It's crucial to remember that the lowest-cost option may not always be the most effective, and consultation with a healthcare provider is essential for developing an appropriate and affordable treatment plan.

Optimizing for Efficiency

When optimizing for efficiency in psoriasis treatment, the goal is to achieve rapid symptom relief and long-term management with minimal time investment. Here are efficient strategies for each severity level:

Mild Psoriasis

• Virtual doctor consultation for quick diagnosis
• Start with over-the-counter treatments immediately
• Use combination topical treatments (e.g., corticosteroid + vitamin D analogue) for faster results
• Implement lifestyle changes concurrently with medical treatments

Moderate Psoriasis

• In-person dermatologist visit for accurate diagnosis and tailored treatment plan
• Combine topical treatments with oral medications for synergistic effects
• Consider at-home phototherapy devices to reduce clinic visits
• Use long-acting medications to minimize dosing frequency

Severe Psoriasis

• Prioritize biologics or combination therapies for rapid, significant improvement
• Opt for medications with less frequent dosing schedules (e.g., monthly injections)
• Utilize telemedicine for follow-up appointments when possible
• Coordinate blood tests with other necessary healthcare visits to save time

General Efficiency Tips

• Choose medications with convenient application methods or dosing schedules
• Use pill organizers or smartphone apps for medication reminders
• Batch-prepare topical treatments for easy application
• Schedule multiple treatments or appointments on the same day when possible

By focusing on efficiency, patients can minimize the time impact of psoriasis treatment on their daily lives while maximizing therapeutic benefits. However, it's important to note that the most efficient approach may not always be the most cost-effective or suitable for every individual. Consultation with a healthcare provider is essential to determine the best treatment strategy.

Balancing Cost and Efficiency

When managing psoriasis, finding the right balance between cost-effective treatment and efficient care is crucial for long-term success. Here's a breakdown of optimal strategies for each severity level:

Mild Psoriasis

1. Diagnosis: Start with a virtual doctor consultation for an initial assessment.
   • Cost-effective and time-efficient
   • Allows for quick prescription of basic treatments if necessary
2. Treatment:
   • Begin with over-the-counter moisturizers and topical treatments
   • If needed, use generic topical corticosteroids prescribed during the virtual consultation
   • Implement lifestyle changes (e.g., stress reduction, dietary adjustments)
3. Follow-up:
   • Schedule a follow-up virtual consultation after 4-6 weeks to assess progress
   • If no improvement, consider an in-person dermatologist visit

Moderate Psoriasis

1. Diagnosis: Schedule an in-person visit with a general practitioner or dermatologist.
   • Allows for a thorough physical examination and immediate treatment initiation
2. Imaging/Labs:
   • Complete basic blood tests to rule out other conditions and assess overall health
   • Consider a skin biopsy only if the diagnosis is uncertain
3. Treatment:
   • Start with a combination of topical treatments (generic options when available)
   • If needed, add oral medications like methotrexate (generic) or consider phototherapy
   • Balance the cost of phototherapy sessions against the long-term expense of medications
4. Follow-up:
   • Schedule regular follow-up appointments (every 2-3 months) to monitor progress and adjust treatment

Severe Psoriasis

1. Diagnosis: Consult with a dermatologist specializing in psoriasis.
   • Essential for developing a comprehensive treatment plan
2. Imaging/Labs:
   • Complete comprehensive blood tests to assess overall health and suitability for treatments
   • Perform a skin biopsy if needed for definitive diagnosis or to rule out other conditions
3. Treatment:
   • Consider a combination of systemic medications and biologics
   • Start with more affordable options (e.g., methotrexate) before progressing to costlier biologics
   • Explore patient assistance programs or biosimilars to reduce the cost of biologic treatments
4. Follow-up:
   • Schedule regular appointments (every 1-2 months initially, then every 3-4 months)
   • Monitor treatment efficacy and adjust as needed

By carefully considering both cost and efficiency at each stage of psoriasis management, patients can work with their healthcare providers to develop a treatment plan that offers the best chance of success while minimizing financial burden. Remember that the most cost-effective approach may evolve as the condition progresses or responds to treatment, so regular reassessment is key to maintaining an optimal balance.

Conclusion

Treating psoriasis can vary significantly in cost and approach depending on the severity of the condition. This article has explored the various aspects of psoriasis treatment, from diagnosis to long-term management, with a focus on associated costs and time investments.

Key takeaways include:

1. Psoriasis treatment costs can range from minimal expenses for mild cases to substantial financial commitments for severe cases requiring biologics or advanced therapies.
2. The severity of psoriasis plays a crucial role in determining the most appropriate and cost-effective treatment plan.
3. There are multiple options for diagnosis, testing, and treatment at each stage, allowing for personalization based on individual needs and resources.
4. Optimizing for cost may involve starting with over-the-counter treatments and gradually moving to prescription options as needed.
5. Efficiency in treatment often comes at a higher cost but may lead to quicker symptom relief and improved quality of life.
6. Balancing cost and efficiency is possible by working closely with healthcare providers to find the most suitable treatment plan.
7. Generic medications and biosimilars can offer significant cost savings without compromising on quality of care.
8. Regular follow-ups and adjustments to treatment plans are essential for managing psoriasis effectively over time.

It's important to remember that while cost is a significant factor, the primary goal of psoriasis treatment is to achieve clear skin and improve overall well-being. Patients should work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs, considering both financial constraints and desired outcomes.

Ultimately, investing in proper psoriasis treatment can lead to better long-term health outcomes and improved quality of life, potentially reducing overall healthcare costs in the future. Always consult with a healthcare professional before making decisions about psoriasis treatment to ensure the best possible care for your individual situation.