August is Psoriasis Awareness Month. With over 3 million cases per year in the U.S., you probably know someone with psoriasis. To understand the inflammatory skin disease and learn more about treatment options, we sat down with Shane Berken, PharmD, about his experience treating GHC-SCW members with psoriasis and a cost-saving research study he conducted to help those that suffer from the disease.
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What is psoriasis?
Psoriasis is a chronic, inflammatory skin disease that comes in multiple forms. The most common form is plaque psoriasis, which is characterized by raised skin patches (plaques) covered with scales which can be itchy. The extent of the affected area varies widely from person to person, but some commonly-affected areas include the elbows, knees, lower back, and scalp. Patients with psoriasis often have comorbidities such as joint pain (psoriatic arthritis), obesity, hypertension, diabetes, and cardiovascular disease. Psoriasis affects 1-2% of the U.S. population, with an even prevalence between males and females, and it has a strong genetic link.
What is the typical regimen for taking care of psoriasis and managing a patient’s psoriasis?
The approach to treating psoriasis varies depending on the severity of the patient’s disease and existing comorbidities. Topical therapies are the mainstay for most patients with mild-moderate psoriasis. Corticosteroids are generally the most effective of the topical therapies, but other topicals are often used in combination with corticosteroids. Phototherapy, which is a treatment that emits a type of UV radiation, administered in clinic or by a special home device is an effective and safe therapy when topicals fail to adequately control disease or when large quantities of topical therapies are required. Oral therapies such as methotrexate can be used for more severe disease and are usually reserved for patients who have tried other treatments. Biologic medications are the most effective type of treatment for severe disease. These are injected under the skin by patients as frequently as twice per week or as infrequently as every 3 months. The cost of biologics therapies is much higher than other treatments, and thus they are reserved for patients whose disease is not adequately controlled with multiple other therapies.
You completed research for GHC-SCW using a different cost saving medication for members with psoriasis! Can you explain what that research was?
At GHC-SCW, we are constantly looking for ways to reduce the cost of medications to our members. This can result in lower copays at pharmacies and lower monthly premiums. For our members with severe psoriasis who required a biologic therapy to control their disease, GHC-SCW worked with our partners to reduce the cost of one of the newer and most effective biologic drugs for psoriasis. By doing this, our members gained access to a very effective and safe therapy at a lower price for the cooperative. The change had a positive impact on members in two ways. The first way is that members who were currently using an alternative biologic therapy were switched to the newer therapy. The second way is that members had access to this therapy when they required treatment with their first biologic. During the transition to the newer biologic, we kept track of our members who were using it to make sure it worked as well as expected.
What were the results of that research? Did you patients/members see an improvement in symptoms in addition to less costs?
GHC-SCW is excited to report that the initiative to lower costs and improve outcomes for our members with psoriasis was a remarkable success. Most of our members experienced some improvement in their skin compared to what they were achieving with their prior biologic, and the members who had complete control of their skin before making the switch did not lose that control. These impressive results were achieved while also reducing costs.
How can GHC-SCW members work with the clinical pharmacy team to adjust their medication for psoriasis and other diseases?
GHC-SCW’s Clinical Pharmacists are well-trained pharmacists who work with our patients and their GHC-SCW care teams to optimize drug treatments and help reduce cost when possible. Some of the ways clinical pharmacists help our patients include: assisting providers with prescribing choices, drug interactions, and dosing; gathering and reviewing a patient’s full list of medications and making recommendations to optimize therapy; meeting with patients directly to address concerns about side effects, drug interactions, drug costs, and more; educating patients about lifestyle and drug treatments, prescribing drugs, and monitoring labs for some chronic diseases. For access to these services, members may reach out to their GHC-SCW provider or GHC-SCW pharmacy!
