More than skin deep – understanding the burden of psoriasis and psoriatic arthritis (PsA)

The timely report presents detailed and far-reaching policy recommendations which seek to manage the personal, socioeconomic and NHS burdens associated with psoriasis and PsA. This includes a distinct emphasis on the importance of a speedy diagnosis and access to holistic management.¹

A lack of national policy relating to psoriasis may be contributing to missed opportunities to delay progression and other associated complications and comorbidities, the report finds. Despite the NHS increasingly using a preventative philosophy for healthcare, and early diagnosis a key driver to improve health, rates of comorbidities amongst people with psoriasis are high.¹

Currently, a third of people with psoriasis go on to develop the inflammatory condition psoriatic arthritis.² Patients with severe psoriasis may be at an increased risk of a range of debilitating comorbidities, including cardiovascular disease, lymphoma and non-melanoma skin cancer.¹

The report’s authors conclude: “Psoriasis is generally seen as a dermatological problem but it is actually an under-recognised and multi-faceted disease in which PsA and other complex comorbidities can develop. There are concerns that the needs of this patient group are being overlooked.”¹

First estimates of national and local psoriasis populations to guide policymaking

The lack of national policy relating to psoriasis means it is largely an invisible problem in which Integrated Care Systems (ICS) have little or limited understanding of the number and needs of people affected, with many not having a specific plan for the delivery of psoriasis, PsA or dermatology care.¹

To address this absence of hard data, the report offers the first estimate of patient numbers at national and local policy making levels. Across the UK there are estimated to be 2.1 million people with psoriasis; and around 640,000 people living with psoriatic arthritis.¹ The report suggests the availability of this data provides a critical opportunity to guide the future commissioning and delivery of services.¹

Spotlight on specific recommendations for commissioners

In tackling some of the issues raised in the report, recommendations for commissioners include prioritising measures that can deliver care to those who need it most, making current waiting times for dermatology and rheumatology appointments explicit to improve visibility of service challenges and providing ICSs with examples of shared-care protocols between community care and secondary care providers that support early diagnosis and rapid care access.

Novartis’ commitment to re-imagining psoriasis and psoriatic arthritis care

Novartis UK, who commissioned the new report, is dedicated to working with policymakers and the NHS to reimagine psoriasis and psoriatic arthritis care for these patient groups. Novartis is dedicated to supporting the NHS in building back better from the pandemic, a commitment which encompasses dermatology and rheumatology care systems.

The report, More Than Skin Deep: The Underlying Burdens of Psoriasis and Psoriatic Arthritis, drew upon contributions from policymakers, clinical professionals and patient advocates gathered during an expert workshop held virtually on 4 December 2020, along with a foreword provided by the former Chair of the All-Party Parliamentary Group on Skin, Sir Paul Beresford MP. The findings are also based on desk research and online commentary from people living with psoriasis and PsA accessed via patient groups and social media. Wilmington Healthcare was commissioned by Novartis to develop this report.

References

1 Thomas S, Thomas S and Mehta S (Wilmington Health). More than Skin Deep: The Underlying Burdens of Psoriasis and Psoriatic Arthritis. December 2021. Available at https://wilmingtonhealthcare.com/More-than-skin-deep-the-underlying-burdens-of-psoriasis-and-psoriatic-arthritis/. Last accessed January 2022.

2 NIHR. Key discovery in psoriatic arthritis points way for developing targeted treatments. Available at https://oxfordbrc.nihr.ac.uk/key-discovery-in-psoriatic-arthritis-points-way-for-developing-targeted-treatments/. Last accessed January 2022.