A paper recently published by Derma Care Access Network,
an advocacy group that supports informed policies on access for dermatological care, discussed a variety of skin conditions that commonly affect Americans and how to overcome the challenges of accessing the necessary care.
Skin conditions affect millions of Americans and often times come with painful symptoms. The specific skin conditions that the paper discusses include:
Atopic dermatitis (eczema): affects more than 30 million Americans
Psoriasis: affects 7.5 million people
Acne: affects 50 million people
Chronic urticaria: affects 15% to 20% of the population
Skin cancer: the most common cancer in the United States that affects 5.4 million people
The authors of the paper emphasized the deeper problems that these skin conditions can cause. For example, those with psoriasis are at a greater risk of associated comorbidities such as diabetes, chronic pulmonary disease, and others. People with these common skin conditions also face high costs for accessing healthcare providers and drugs for treatment. According to the paper, the direct cost of skin disease is nearly $75 billion a year and 61% of that total is attributed to medical costs.
Patients who seek treatment for their skin conditions often face the difficulty of finding an available specialist in their area, as many only practice in densely populated areas, the authors explained. Additionally, some health plans do not cover dermatologists’ visits including many practices that lack the resources to process patients who have Medicare or Medicaid.
“Patients with moderate-to-severe conditions, however, typically do need to see a specialist," the report noted. "Yet a shortage of dermatologists, reportedly driven by a shortage in available training spots for medical students hoping to enter the field, makes finding an available dermatology care provider challenging. Although only 20% of dermatologists focus on cosmetic treatments and procedures rather than treating traditional skin conditions, wait times to see a dermatologist can be painfully long.”
The access challenges are continued once a patient meets with a dermatologist, as many of the sophisticated biologic medicines have high costs and many health plans require prior authorization for these biologic treatments. The prior authorization may include step therapy, which would require patients to fail a lower-cost treatment that the insurers prefer before getting approved for the innovative treatment.
In response to the difficulty of treatment access for skin conditions, new state bills have been introduced. Legislation in certain states have imposed limitations on when health plans can require step therapy. The paper suggested that additional federal and state legislation is needed in order to prioritize patient treatment.
“Proper dermatological care stands to improve patients’ health, productivity and quality of life. But those improvements are predicated on access to the specialists who can guide their treatment and the innovative medicines that can change their lives,” the authors concluded.