Taking biologics
Who can take biologics?
Doctors are most likely to recommend biologics for people with moderate to severe cases of psoriasis and psoriatic arthritis. Biologics could be a promising option for people who have not responded to other "conventional" treatments, who have experienced harmful side effects from other treatments or who can't take some medications because of those side effects. For example, people with liver problems are not eligible to take methotrexate, and people with a history of skin cancer would not be suitable for phototherapy. In some cases, biologic medications may not be prescribed if a person's immune system is already significantly compromised—for example, if the person is on another medication that is suppressing his or her immune system. People with active infections may not be eligible for some biologics. If a major infection develops while taking a biologic, it is usually recommended that the medication be temporarily stopped. Screening for tuberculosis (TB) or other infections may be required before treatment is started with certain biologics. And many dermatologists are screening for TB even when it's not required.
Key features of biologics
- Taken by injection (either in a doctor's office or at home, depending on the medication) or by infusion
- Treatment schedule and frequency varies
- Will improve psoriasis and/or psoriatic arthritis for some patients, but not all
- Different set of risks than other systemic treatments
- Short-term side effects are generally mild
- Long-term safety is still being evaluated
- Expensive: Usually $10,000 or more per year
How effective are biologics?
Biologics can be very effective at improving psoriasis and psoriatic arthritis, but how well they work will vary for each person. For some people, biologic treatments may not work at all for their disease. For others, one biologic may not work but another may be effective. People should talk to their doctors about the best treatment option for their individual case of psoriasis and/or psoriatic arthritis.
What are the side effects?
The side effects for biologic medications vary. Common side effects for all biologics include respiratory infections, flu-like symptoms and injection site reactions (such as swelling, itch or rash). These are generally mild and, in almost all cases, do not cause people to stop taking the medication.
Biologics for psoriasis and psoriatic arthritis are still relatively new. As such, their overall safety is still being evaluated. Anyone considering a biologic medication should talk with his or her doctor about the short- and long-term side effects and risks, and carefully weigh those against the risks of other treatment options.
How do I get a biologic medication?
Biologics are available by prescription from a doctor. Some are given only in a doctor's office. Some can be self-administered, which patients can learn to do with training from the doctor's office. In addition, some insurance plans work with specific mail-order pharmacies to provide patients with the medications. The companies that make biologics have special programs to help patients obtain the medication, get insurance coverage and take other necessary steps.
Please refer to the related links at the bottom of this page for details on the special programs for each specific medication.
How expensive are biologics?
Biologics are very complex medications to make, and it can take decades of research and development before a biologic is approved for patient use. The high cost of creating these medications is one reason given for their high cost: $10,000 or more per year depending on the dose and the frequency of treatment.
Patients have varying experiences getting these treatments covered by health insurance. Depending on insurance company policies, some patients will be fully covered for a biologic; others may be partially covered or, in some cases, may have to pay some portion of the total cost out of pocket. For some biologics, companies may require prior insurance authorization.
Companies that make biologics have special programs to help patients with insurance issues. In addition, they may offer discounted prices on medications for people who meet certain income and financial requirements. Your doctor's office should be able to help you obtain the necessary authorization required for insurance coverage.
Updated Nov. 2006
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