The National Institute for Health and Care Excellence (NICE) has approved a number of different treatments for psoriasis as part of its technology appraisal (TA) programme, the most recent of these being Secukinumab, which was recommended as a possible treatment for people with plaque psoriasis in July 2015. The National Health Service is legally obliged to fund medicines and treatments recommended by NICE's TA programme, meaning people can access these treatments wherever they live in the country.
Information regarding the cost to the NHS of the continued treatment of psoriasis patients who do not achieve 75% skin clearance is not collected. The NICE best practice guideline Psoriasis: assessment and management, published in October 2012, covers approaches to diagnosis and treatment and specialist referral. The majority of TA recommended psoriasis treatments are featured in the guideline, and their success in treating psoriasis is measured using Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index. PASI is a quantitative rating score for measuring the severity of psoriatic lesions based on area coverage and plaque appearance. In most cases, NICE defines an adequate response to treatment as one that includes a 75% reduction in a PASI score. The NICE guidance can be found at the following link:
For patients who do not responded adequately to either topical treatment or biological therapies, such as those recommended by the NICE TA programme, the guidance recommends referral to a specialised service. NHS England commissions specialised dermatology services nationally and has set out what providers must have in place in order to deliver specialised dermatology care, as well as defining referral criteria. For psoriasis patients, referrals are appropriate where their condition is severe and they have not responded to NICE approved biological therapies. More information on specialised dermatology services can be found at the following link: