Access to care
The health care issues people with psoriatic disease face are at the core of the health care crises at large. Many people with psoriasis and psoriatic arthritis are not receiving the care they need to live productive and healthy lives, largely due to lack of adequate health insurance. While some new treatments recently have been developed, too many people with psoriasis currently lack sufficient effective, safe and affordable treatment options.
People with psoriasis need adequate medical care to manage their condition, and insurance coverage that ensures that care. We are working with health care insurers, government and individuals to end health insurance policies and procedures that are harmful to people with psoriasis and psoriatic arthritis.
Out-of-pocket costs such as copayments, premiums and deductibles are rising at an alarming rate and the number of families facing unmanageably high health care costs is growing.
- Learn about our ground-breaking state legislative initiative to reduce copays for phototherapy treatment.
- The Foundation supports federal legislation to decrease out-of-pocket costs for prescription medications. Medicare members are particularly affected by high copays and the "doughnut hole".
- State legislation supported by the Foundation in New York seeks to curb a growing trend in which insurance companies create a "specialty tier" for high-cost medications such as biologics, requiring patients to pay a percentage of the cost of the medication.
Insurance policy requirements can stand between patients with psoriasis and psoriatic arthritis and the treatment prescribed by their doctor. The Psoriasis Foundation works directly with insurance companies to identify problematic policies and negotiate improvements. Examples of policies challenged include:
- Step therapy, commonly imposed in regard to biologic drugs, can require patients to:
- Try and fail two or more other treatments before qualifying for a biologic treatment;
- Fail one or more biologic before trying another—when a biologic treatment has been determined by the doctor to be the right choice for a particular patient;
- Follow a regimen that has already proven to be ineffective, is contraindicated, or not recommended by a physician.
- Requiring a significant body surface area (BSA) to be affected for patients to qualify for certain treatments. This limitation excludes patients who may have a small area affected, but experience significant pain and disability.
- Arbitrary imposition of time requirements, such as denying certain treatments to patients until they exhibit disease symptoms for as much as a year, or limiting the number of treatments within a certain time frame.
- Physician tiering—patients of physicians who prescribe more expensive medications are charged higher copayments. Physician tiering can force a patient to choose between paying more out-of-pocket to see his or her current doctor or going to an insurance "preferred" physician who may not have the same depth of knowledge in treating the patient's disease.
- Find out about improved insurance policies for people with psoriasis and psoriatic arthritis.
Reforming the health care system is a long and complicated process requiring careful thought and attention. The National Psoriasis Foundation is committed to ensuring that the needs of people with psoriasis and psoriatic arthritis are addressed in the components of health care reform.
- The National Psoriasis Foundation is aligned with the National Health Council health care reform initiatives and policy priorities related to accessing health care.
- As President Obama took office, the Foundation brought to his attention the importance of changes in the health care system for people with psoriasis and psoriatic arthritis. Download the PDF>>>
- A proposal for a new health care payment system in Massachusetts could have consequences for patients with psoriatic disease and the doctors who treat them. Read our letter to the Governor and Joint Committee on Health Care Finance (PDF).
We need your help to challenge the barriers that keep people with psoriasis and psoriatic arthritis from accessing health care. Take action: