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To compare the impact of Psoriasis Area and Severity Index (PASI) response on total work productivity impairment (TWPI) in patients with moderate-to-severe psoriasis; to compare TWPI and associated indirect costs among patients treated with risankizumab, adalimumab, ustekinumab, and placebo. Data from REVEAL (adalimumab phase III trial) were used to assess differences in trial-observed TWPI across PASI response cohorts. A machine learning model used REVEAL data to predict TWPI for patients in the risankizumab trials. These values were used to estimate work loss hours and work impairment-related indirect costs for each treatment cohort. Among REVEAL patients ( N  = 741), TWPI in the PASI 100, 90–99, 75–89 cohorts was lower than the PASI &lt;75 cohort ( p  &lt; .05); mean TWPI was lowest with PASI 100 (1.7%)  vs.  90–99 (2.5%)  vs.  75–89 (4.8%)  vs.  &lt;75 (14.3%). There was a significant ( p  &lt; .0001) monotonic relationship between higher PASI response and lower TWPI. In the risankizumab trials ( N  = 2046), incremental TWPI relative to risankizumab was 3.4%/week for ustekinumab/adalimumab, and 17.1%/week for placebo; incremental indirect cost savings for risankizumab were $2179/year  vs.  adalimumab, $2321/year  vs.  ustekinumab, and $11,284/year  vs.  placebo. Higher PASI responses were associated with reduced TWPI. Risankizumab was associated with less work impairment/indirect costs  vs.  ustekinumab/adalimumab/placebo.

journal of dermatological treatment

Impact of PASI response on work productivity and the effect of risankizumab on indirect costs using machine learning in patients with moderate-to-severe psoriasis