The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives

Abstract The management of psoriatic disease has been revolutionized by biologic medications in recent years. Despite their efficacy and safety, patients are often required by insurance plans in the USA or national formulary guidelines in other countries to try and fail other treatments first, which...

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Main Authors: Georgia Marquez-Grap, Dayna L. Pham, Andrea Leung, Melissa C. Leeolou, Allison Kranyak, Wilson Liao
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-05-01
Series:Dermatology and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s13555-025-01430-1
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author Georgia Marquez-Grap
Dayna L. Pham
Andrea Leung
Melissa C. Leeolou
Allison Kranyak
Wilson Liao
author_facet Georgia Marquez-Grap
Dayna L. Pham
Andrea Leung
Melissa C. Leeolou
Allison Kranyak
Wilson Liao
author_sort Georgia Marquez-Grap
collection DOAJ
description Abstract The management of psoriatic disease has been revolutionized by biologic medications in recent years. Despite their efficacy and safety, patients are often required by insurance plans in the USA or national formulary guidelines in other countries to try and fail other treatments first, which is a strategy called step therapy. Originally designed to contain costs of specialty drugs, step therapy has a number of negative impacts on patients and providers, both personally and clinically. This article is coauthored by a patient with psoriasis and psoriatic arthritis who navigated step therapy. She describes her early experiences with psoriasis and achieving disease control with biologic medication, only to later be diagnosed with psoriatic arthritis and need to revise this treatment plan. She then explains how insurance denials and step therapy impact her life physically, emotionally, socially, and medically. This case is then discussed from the perspective of a dermatologist specializing in inflammatory skin disease. We highlight the psychosocial burden of psoriatic disease, as well as the burden of step therapy and its impacts on patients, providers, and the entire medical system.
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series Dermatology and Therapy
spelling doaj-art-96acc8ee3eef4be88bac5e23f6a7b2622025-08-20T03:16:52ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722025-05-011571599160610.1007/s13555-025-01430-1The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider PerspectivesGeorgia Marquez-Grap0Dayna L. Pham1Andrea Leung2Melissa C. Leeolou3Allison Kranyak4Wilson Liao5Department of Dermatology, University of California, San FranciscoPatient AuthorDepartment of Dermatology, University of California, San FranciscoDepartment of Dermatology, Stanford UniversityDepartment of Dermatology, University of California, San FranciscoDepartment of Dermatology, University of California, San FranciscoAbstract The management of psoriatic disease has been revolutionized by biologic medications in recent years. Despite their efficacy and safety, patients are often required by insurance plans in the USA or national formulary guidelines in other countries to try and fail other treatments first, which is a strategy called step therapy. Originally designed to contain costs of specialty drugs, step therapy has a number of negative impacts on patients and providers, both personally and clinically. This article is coauthored by a patient with psoriasis and psoriatic arthritis who navigated step therapy. She describes her early experiences with psoriasis and achieving disease control with biologic medication, only to later be diagnosed with psoriatic arthritis and need to revise this treatment plan. She then explains how insurance denials and step therapy impact her life physically, emotionally, socially, and medically. This case is then discussed from the perspective of a dermatologist specializing in inflammatory skin disease. We highlight the psychosocial burden of psoriatic disease, as well as the burden of step therapy and its impacts on patients, providers, and the entire medical system.https://doi.org/10.1007/s13555-025-01430-1BiologicsInsurancePrior authorizationPsoriasisPsoriatic arthritisStep therapy
spellingShingle Georgia Marquez-Grap
Dayna L. Pham
Andrea Leung
Melissa C. Leeolou
Allison Kranyak
Wilson Liao
The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
Dermatology and Therapy
Biologics
Insurance
Prior authorization
Psoriasis
Psoriatic arthritis
Step therapy
title The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
title_full The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
title_fullStr The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
title_full_unstemmed The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
title_short The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives
title_sort impact of step therapy on individuals with psoriatic disease in the usa patient and provider perspectives
topic Biologics
Insurance
Prior authorization
Psoriasis
Psoriatic arthritis
Step therapy
url https://doi.org/10.1007/s13555-025-01430-1
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