Prevalence of Utilization Management Policies Among the Psoriatic Disease Community: Results From the 2019 National Psoriasis Foundation Advocacy Survey

Abstract

Introduction:

Utilization management (UM) policies are becoming more common among commercial insurance policies. However, little research has been conducted to understand the prevalence of experiencing UM restrictions among patients with psoriatic disease.

Objectives:

To understand the prevalence of UM policies within the psoriatic patient community and examine their relationship with patient characteristics.

Methods:

An online survey of 1205 individuals with a psoriatic disease from the National Psoriasis Foundation’s constituent database was conducted. Data were collected from July 7 to July 31, 2019. The main outcomes of interest for the present study were frequency of experiencing UM policies (eg, prior authorization [PA] or step therapy [ST]) from their insurance company, number, and type of UM policies experienced and relationship between patient characteristics and experiencing these policies.

Results:

Survey respondents reported high rates of experiencing some form of UM restriction (80.5%). Nearly half (45.1%) of the survey respondents indicated their insurer required them to try a therapy other than the therapy originally prescribed by their physician, a practice known as ST or “fail first” and 73% of respondents reported having to receive PA from their insurer before initiating treatment.

Conclusions:

Individuals with psoriatic disease commonly encounter UM policies from their insurer when attempting to manage their disease. Statistical analyses suggest that UM policies are related to the type of treatment used by patients and the type of psoriatic disease.