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Health Equity Across All Skin Phototypes

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

Ryan Haumschild, PharmD, MS, MBA: Dr McMichael, how can we better educate providers on how to include ethnicity and cultural backgrounds when considering unique treatment selections?

Amy McMichael, MD: Great question. I think what we need to do is, we need to get psoriasis content experts to provide that information. When they’re standing at the podium, when they’re publishing, when they’re working with other physicians in their offices, in their environment, in their cities, I think we need to get the information out. That’s literally what we need to do. I think the writing is on the wall about prevalence, the writing is on the wall about people of different ethnic backgrounds getting differential care. Dr Sherman referred to the fact that about 70% of patients of color, Black individuals, were not getting biologics. So I think these statistics need to be discussed, and then we need to start putting out ways we can break these barriers down. I think the content experts around psoriasis are the best folks to do that.

Ryan Haumschild, PharmD, MS, MBA: And almost creating treatment pathways, leveraging those unique data, to have a unique treatment algorithm that best meets the needs of that patient and ultimately provides the best health outcome.

Dr Sherman, I’m curious, from your perspective, since you’ve been in this field for a while and you’re making an impact, what lessons can we have for all providers? How can health care providers mitigate disparities in care across all skin phototypes for patients with psoriasis?

Bruce Sherman, MD, FCCP, FACOEM: I think the biggest issue is returning to a truly patient-centered approach to care delivery, in recognizing the unique attributes of every patient. Dr Lopes alluded to this earlier, asking patients what matters to them is perhaps the best way to zero in on what’s important to the patient. Not what we see as clinicians that we can treat, but what is actually important to the patient? Having a sense of cultural humility, and understanding differences. For example, I think I mentioned previously, I started looking at individuals of color being more focused on concerns about the risks of specialty drugs than White people. Not having a one-size-fits-all approach to patient care may be the best way to zero in on truly what matters to the patient. Then allow that to guide the discussion, not what quality metrics the provider is necessarily focused on achieving.

Ryan Haumschild, PharmD, MS, MBA: How can we include more discussions around health equity with our colleagues, with our providers and our payers, but specifically with patients, to make a direct impact in this space?

Bruce Sherman, MD, FCCP, FACOEM: My sense is that thanks to COVID-19 in large part, we as a health care community have become much more cognizant of racial socioeconomic differences in the way individuals are responding to health issues. With COVID-19, for example, there were inequities in individual housing that contributed to disparities in prevalence rates of COVID-19, particularly in urban areas, high-density population areas where the spread of COVID-19 was much faster, as a result. That door is open; I don’t think it’s going to close. And as a result, there has been a plethora of research studies looking at differences in health care service delivery, and looking at socioeconomic status, social needs, that are helping to uncover the fact that we can no longer treat a population as a homogeneous group. We have to look at social factors and unmet social needs. We have to look at race and ethnicity to be able to understand what are the barriers to effective care delivery, and how can we overcome those to give everybody a chance to have their best health.

Transcript edited for clarity.

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