Another step toward keeping phototherapy available and affordable

| Melissa Leavitt

Every time a new treatment for psoriatic disease becomes available, you know that a lot of hard work has paid off. Scientists, physicians and groups like the National Psoriasis Foundation (NPF) have come together to achieve progress that you can see. But sometimes, all that hard work pays off to achieve results that you never see.

That’s because, on top of efforts to deliver new treatments to patients, NPF works hard behind the scenes to make sure that all treatment options stay affordable and accessible. By working with lawmakers in Washington and all across the country, and partnering with organizations like the American Academy of Dermatology (AAD), NPF strives to maintain—and improve—patient access to the full range of therapies available.

In some cases, that might mean that you can afford a new drug when it comes on the market. Other times, it might mean that you can keep benefitting from the same treatment that’s already working for you, without any disruptions to your heath care. It’s the kind of thing you notice when things go wrong, but not so much when everything is working well.

Recently, people who use phototherapy scored a victory they might never notice. The Centers for Medicare and Medicaid Services (CMS) decided not to reduce phototherapy reimbursements to doctors. When reimbursement rates stay the same, doctors can keep offering phototherapy—which means that patients don’t have to stop their phototherapy treatments, or find a new provider.

In response to the encouraging news, NPF took further action in an ongoing effort to ensure that people who use phototherapy can keep accessing their treatment without having to worry about rising costs or limited availability.

Phototherapy, or light therapy, is used to treat psoriasis and other skin conditions such as vitiligo and eczema. As a safe and effective treatment, it is the front-line option for many people with psoriasis whose choices are limited, including children, pregnant and nursing women and people with suppressed immune systems.

CMS’s decision to uphold current phototherapy reimbursement rates is a promising step toward keeping this much-needed treatment accessible and affordable. CMS oversees health care coverage for people on Medicare and Medicaid. But its influence doesn’t stop there. Because private insurance companies tend to follow the lead of CMS, their policies can affect health care decisions across the country.

In 2013, CMS considered drastically cutting phototherapy reimbursement rates by as much as 60 percent. However, a persuasive effort by NPF and other patient and physician advocates halted this cut. After receiving comments from NPF and its supporters, CMS decided to only reduce reimbursements by 9 percent.

This year, when CMS released its proposed Physician Fee Schedule—which, because it determines how much doctors will be paid for their services, can directly impact patient treatment options—it did not include further cuts to phototherapy. Earlier this week, NPF sent a letter to CMS applauding this decision.

But that doesn’t mean NPF has stopped advocating for patients who receive phototherapy. The letter also addresses other policies that CMS has proposed, and makes the case for improving patient access to many different treatments, including biologics and other systemic drugs.

As more and more new treatments come on the market, growing numbers of people with psoriasis and psoriatic arthritis can benefit from the full range of options available.  By partnering with patients, physicians and organizations such as the AAD, NPF works hard to ensure that people living with psoriatic disease can access and afford the treatments they need. 

Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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