Clinical Characteristics, Healthcare Resource Utilization, and Costs of Patients with Generalized Pustular Psoriasis in Taiwan: A National Claims Database Study.

Background: Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread pustular eruptions and systemic inflammation. Objective: To evaluate the clinical characteristics and disease burden of patients with GPP in Taiwan using a national claims database. Methods: Patients with GPP and no prior diagnosis of psoriasis vulgaris (PV) who experienced an incident flare between January 1, 2017, and September 30, 2020, were identified from Taiwan's National Health Insurance Database. Clinical characteristics, comorbidities, and treatment patterns were described. Recurrent flare frequency, healthcare resource utilization (HCRU) and costs were compared with those of a propensity score-matched PV cohort at a ratio of up to 1:4. Outpatient-managed flares were classified as moderate, whereas hospitalized flares were classified as severe. Results: A total of 245 patients with GPP were included (mean age 51.3 years; 49.8% male). During follow-up, 1,156 moderate-to-severe flares were identified. Compared with matched patients with PV, patients with GPP had a higher recurrent flare rate (rate ratio 1.14; 95% CI 1.06-1.23). Patients with GPP also had greater HCRU, including more outpatient visits (incidence rate ratio [IRR] 1.03 [95% CI 1.01-1.05]), emergency room visits (IRR 1.33, 95% CI 1.19-1.49), and hospital admissions (IRR 1.69 [1.50-1.91]). Median monthly healthcare costs were approximately twice as high among patients with GPP as among matched patients with PV. Conclusion: Patients with GPP experienced recurrent flares, greater healthcare utilization, and higher healthcare costs than matched patients with PV, underscoring the substantial real-world clinical and economic burden of GPP.