Biologic Costs for Plaque Psoriasis Doubled Since 2007, Study Finds

A new analysis shows the average net annual cost of first-line biologic treatments for plaque psoriasis more than doubled between 2007 and 2021, rising from $21,236 to $47,125.

The study researchers, publishing online in JAMA Dermatology, conducted a cross-sectional analysis of 76,781 commercially insured, biologic-naïve patients with plaque psoriasis who initiated treatment with tumor necrosis factor-α (TNF-α) or interleukin (IL) inhibitors over a 14-year span. Drawing from a national commercial claims database, the study tracked demographic and clinical factors linked to treatment initiation and assessed estimated net drug costs.

Prescribing patterns shifted over the study period. TNF-α inhibitors were dominant in earlier years: by 2021, 63% of patients strated treatment with newer IL-23 or IL-17 inhibitors. Risankizumab was the most commonly initiated agent despite being the most expensive ($70,043 per year). This was more than five times the cost of the least expensive option, infliximab biosimilars ($12,413 per year).

Had patients consistently initiated the lowest-cost biologic within each mechanistic class, the average annual treatment cost in 2021 would have been 44% lower ($26,363 per year), the study revealed.

The researchers noted that patient characteristics played a significant role in drug selection. Men, older patients, and those without inflammatory comorbidities were more likely to begin IL inhibitor therapy. Geographic variation also factored in, with patients in the Northeast having higher odds of initiating IL inhibitors than those in the South. Individuals with inflammatory arthritis, IBD, or those who had used systemic or topical therapies were more likely to start with TNF-α inhibitors.

“This cross-sectional study found that from 2007 to 2021, treatment costs increased for biologic medications used to treat plaque psoriasis,” the authors concluded. “Substantial savings are available if more patients and physicians use the lowest-cost options and/or if drug prices were better aligned with the comparative effectiveness and safety of each medication.”

Source: Rome Benjamin N., et al. JAMA Dermatology. 2025. doi:10.1001/jamadermatol.2025.0669