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Final Thoughts on Psoriasis Across Skin Types


A panel of experts provide their final thoughts on treating psoriasis across all skin phototypes.

Ryan Haumschild, PharmD, MS, MBA: Thanks to all of you for this rich and informative discussion. Before we conclude, I’d like to get final thoughts from each of my colleagues here. Dr McMichael, as you summarize the discussion we’ve had today about psoriasis and how we can impact underserved patient populations and those in greatest need, what are some final thoughts you have for our viewers?

Amy McMichael, MD: As I do with all of these kinds of conversations, I’ve learned a lot today. I think all of us have to keep talking to our colleagues so we can all learn that folks with skin of color do have psoriasis. We know that prevalence is there and that we sometimes miss it, that access and other social determinants are going to be barriers to care. But we need to all push forward for education for the patient, for the employers, for the insurance providers, about how we can better serve these patients. I think if we continue to do that, we’re doing the best that we can for the patient. Specifically, I know what I’m taking from this, one of the pearls that I’ve written down from Dr Lopes, is that the most expensive drug is a drug that is not taken, or the drug that is giving an adverse effect or is causing a problem. So I think if we keep that in our minds in terms of treatment of these patients, we’ll keep their pocketbooks in our heads too. I think we have to talk about what we can do for our group here, the group of us here who are in the health care world, but also for the patient, and make sure we think of the patient at the center of all of this.

Ryan Haumschild, PharmD, MS, MBA: I love your holistic approach. We all need to rally together because we all have a unique role to play. Dr Lopes, from your perspective as a managed care executive, what are some of your final thoughts?

Maria Lopes, MD, MS: I think these forums are great. They are about involving the stakeholders. I guess what’s missing here today would be the patient perspective, but I do think there’s a huge unmet need for education at so many different levels. I think it starts with education and awareness. I think it’s also a wonderful opportunity for best practices. How can we bring the dermatology view and the algorithm [together]? I love what Dr McMichael talked about in terms of CME [continuing medical education] case studies, the treatment algorithm approach. How this is illustrated with different cases and biopsies that then illustrate different paths in terms of how that has implications for treatment in the patient journey. But also best practices around the shared decision support. The future role of technology and digital apps and solutions [is important] that hopefully can not only connect with patients in terms of meaningful education and engagement, but also how that information can be shared with other stakeholders, including payers and specialty pharmacy and clinicians, in a much more timely fashion. Then finally, the whole health approach, I love that. Dr Sherman and Dr McMichael referred to it. But the patient really is at the center of all this. Many of these patients are already in the system as far as other comorbidities, and what a missed opportunity if we miss providing some education and identification in properly addressing psoriasis, to the extent that it’s also a patient concern. It’s a great opportunity for pilots, a great opportunity for further enhancing knowledge across multiple stakeholders.

Ryan Haumschild, PharmD, MS, MBA: I agree. This is an opportunity we really can’t miss anymore. Dr Sherman, final thoughts from you?

Bruce Sherman, MD, FCCP, FACOEM: I think my esteemed colleagues Dr Lopes and Dr McMichael have said just about everything there is to say, but I would add one more point on the topic, and that is data. We need to understand what are the root causes of the observed disparities or inequities in care delivery to be able to address them directly. And it may be that in different clinical settings, there are differences in what the issues are, whether it’s implicit bias from a provider perspective, whether it’s a medication that’s being prescribed but not filled, abandoned at the pharmacy by the patient. We need to understand where the issues are to be able to address them and effectively resolve them so that everybody has an opportunity to receive the best care for psoriasis.

Ryan Haumschild, PharmD, MS, MBA: Excellent. Thank you, again, to our esteemed experts here today for a great discussion, and thank you to our viewing audience. We hope you found this AJMC®Stakeholder Summit to be useful and informative.

Transcript edited for clarity.

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