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Financial Burden on Psoriasis Patients


Bruce Sherman, MD, FCCP, FACOEM, underlines how to support patients financially to afford therapies and maintain adherence.

Ryan Haumschild, PharmD, MS, MBA: We’ve talked about a lot of things: diagnosis, underdiagnosis, and bringing patients to be part of that care decision. One of the biggest things we might have touched on a little earlier is financial toxicity. These biologics might be expensive. There might be greater health care resource utilization needs. How do we consider that? Dr Sherman, I want to pivot to you. How are you supporting patients financially to afford these therapies and maintain that appropriate adherence?

Bruce Sherman, MD, FCCP, FACOEM: In the commercial insurance world, from an employer perspective, 1 of the things…is how we’re being individuals. If patients with psoriasis are treated effectively and have high levels of well-being, then that will not only reduce absentees but also promote employee engagement at work. In this age of thegreat resignation, [with high] turnover, employee retention is critical. When one thinks about investing in workers as an organizational asset, rather than doing benefits as a cost of doing business in support of the workforce. Then it becomes a little easier for employers to understand that making strategic investments in employees to improve their health and well-being has business value. We have to shift the conversation away from how much more financial support do I need to provide to what value am I going to receive for providing additional supports for employees. That can be very helpful. To that end, equitable benefit design is a critical component for those individuals, particularly those at the low end of the wait spectrum. These individuals may be overrepresented by people of color. It’s important to acknowledge the significance of that and to provide subsidies.

In addition, a number of employers have implemented co-pay accumulator adjustment programs, where any patient assistance that those individuals receive from the manufacturer of the drug is a way of subsidizing the patient. Those don’t count toward the patient’s deductible. The net result is, after a few months of receiving medication, all of a sudden the patient is faced with a substantial bill, which may be on par with the full amount of their deductible. That could be 20% of that individual’s overall income. [We need to] help employers understand how to provide employees with a more equitable benefit design and steer clear of co-pay accumulator adjustment programs, which unfortunately are creating bias or inequity for the lowest-earning members of the workforce. Those are 2 cornerstone components. In addition, another option is to refer individuals to patient-assistance or independent patient foundations that can provide support with medications.

Ryan Haumschild, PharmD, MS, MBA: You did a good job articulating how those indirect costs nowadays become more direct costs not only for the organization.

Bruce Sherman, MD, FCCP, FACOEM: Yes.

Ryan Haumschild, PharmD, MS, MBA: How do we help alleviate that financial toxicity and that financial vulnerability to create better access? Ultimately, adherence and a more engaged productive workforce.

Transcript edited for clarity.

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