New study uncovers the impact of racial, economic factors on psoriasis treatment

| Melissa Leavitt

Everyone living with psoriasis or psoriatic arthritis knows firsthand how hard it can be to manage a chronic disease. From getting in to see a dermatologist or rheumatologist to paying for medications, striving to stay healthy can feel like a full-time job for psoriatic disease patients.

For many people of color, these hurdles may be even tougher to overcome. A congressional briefing  organized by the National Psoriasis Foundation, held at the U.S. Capitol on Oct. 22, brought to light some of the challenges faced by people of color who have psoriatic disease.

According to Dr. Paul Wallace, a dermatologist at Wallace Medical Group Inc. in Beverly Hills, California, and Dr. Amy McMichael, the chair of dermatology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, who both spoke at the briefing, people of color may have difficulty accessing specialists who are trained to effectively treat psoriasis, and some are struggling to afford their psoriasis treatments.

A recent study offers a glimpse into the impact that racial and other factors may have on a patient’s ability to receive the best treatment for their psoriasis. Published in July in the Journal of Investigative Dermatology, the study looked at treatment patterns—particularly the use of biologic drugs—among patients on Medicare.

After analyzing records from almost 800,000 Medicare beneficiaries, researchers found that African-American psoriasis patients on Medicare may be less likely to receive biologic treatment, and that economic and geographic factors play a part in access to biologics as well.

According to the findings, about 76 percent of patients used topicals, and 14.3 percent used oral systemic medications, with the majority of these on methotrexate. About 10 percent used biologics.

Looking at other information about these patients, such as race, geographic location and type of prescription coverage, researchers analyzed various demographic factors that could make a patient less likely to use biologics.

Chief among these factors were prescription drug coverage and race. Researchers found that patients who did not have a Medicare Part D low-income subsidy, which offers assistance to people who qualify in paying for prescription drug costs, were 70 percent less likely to use biologics. In addition, African-American patients were approximately 70 percent less likely, compared with white patients, to be on biologics, researchers reported.

Some of the factors that made a psoriasis patient more likely to be on biologics, according to the findings, were living in an urban county and having another condition, such as psoriatic arthritis, that could also be treated with biologics.

This study is the first to examine treatment of psoriasis among people on Medicare and indicates the need for further study into the management of psoriasis among elderly people, researchers noted. Shedding new light on some of the treatment challenges faced by African-American patients in particular, it also illuminates the health care disparities often experienced by racial and ethnic minorities in the United States.


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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