In the first known study to examine the prevalence and treatment of psoriasis in older Americans, experts from the Perelman School of Medicine at the University of Pennsylvania have found that black patients receiving Medicare are less likely to receive biologic therapies –medications derived from human or animal cells or tissues – for the treatment of moderate to severe psoriasis than white patients. Additional results show that psoriasis patients who do not have low income subsidy (LIS) – additional coverage provided for prescription drugs, also known as Medicare Extra Help – as part of their Medicare prescription drug coverage (Part D) plan are less likely to receive biologics than Medicare recipients with full low income subsidy benefit. The findings, presented in the December issue of theJournal of Investigative Dermatology, are the first to suggest the presence of economic and racial barriers that impact the treatment of moderate to severe psoriasis.

Psoriasis is a common chronic inflammatory disorder, primarily of the skin. In the past decade, several targeted biologic therapies have been approved for the treatment of moderate to severe psoriasis, greatly increasing the therapeutic options for this skin disorder that has no cure. Yet most psoriasis patients remain inadequately treated or unsatisfied with their therapies. Despite being effective treatments for psoriasis, access to biologics, which are given by injection or intravenous infusion, remains a challenge for many patients due to various factors including limited insurance coverage and high out-of-pocket costs.

“Previous studies have shown that psoriasis is associated with major physical and psychosocial health burdens that increase proportionally with more severe disease,” lead author Junko Takeshita, MD, PhD, a dermatologist at Penn Medicine, said. “Although the biologics are generally regarded as being highly effective treatments for patients with moderate or severe psoriasis, our results suggest that out-of-pocket costs and race may impact who receives these treatments.”

Using data from a nationally representative sample of Medicare beneficiaries in 2011 to identify patients with psoriasis, the researchers aimed to identify the prevalence of psoriasis among Medicare beneficiaries who are actively receiving medical care, examine their clinical characteristics, and determine the prevalence of psoriasis therapies, specifically focusing on identifying factors that may make it more or less likely for a patient to receive biologic medications.

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