Barriers Imposed by Insurance Companies to Biologic Therapy in Patients with Moderate-to-Severe Psoriasis

Abstract

Psoriasis is a chronic, multisystem autoimmune disease that has affected over 7.5 million Americans to date. The annual cost of psoriasis in the United States is $5,508/patient per year. These patients typically incur greater health care costs compared to the general population, especially those patients with more extensive disease. This rise in health care costs is largely due to the increasing expense of new therapies such as biologics. Biologics have revolutionized psoriasis treatment, but the lack of generic alternatives has made this medication very expensive. Further limiting the accessibility of biologics is the overwhelmingly restrictive nature of health insurance policies. Practices such as tiered cost-sharing, high out-of-pocket costs, step-therapy, coverage gaps, rigid preauthorization policies, and burdensome re-authorization policies have obstructed access to biologic therapies. These barriers have not only made biologic therapy unattainable for most patients but have delayed treatment resulting in inadequate care.