Utilization Management Barriers Among Patients With Cicatricial Alopecia

March 2023 | Volume 22 | Issue 3 | 312 | Copyright © March 2023


Published online February 17, 2023

Katelyn J. Rypka BSa, James T Pathoulas MDa, Kris J. Wharton MSc, Jean R. Pickford BAc, Morinola T. Shobajo BAd, Itisha S. Jefferson BSe, Colleen Leader BAc, Maryanne M. Senna MDf, Ronda S. Farah MDb, Maria K. Hordinsky MDb

aUniversity of Minnesota Medical School Twin Cities, Minneapolis, MN
BDepartment of Dermatology, University of Minnesota, Minneapolis, MN
cScarring Alopecia Foundation, Kulpsville, PA
dUniversity of Illinois College of Medicine, Chicago, IL
eStritch School of Medicine, Loyola University, Chicago, IL
fHarvard Medical School-Massachusetts General Hospital, Department of Dermatology, Boston, MA



championed by a coalition of patient organizations and industry (Figure 1). However, specific regulation of commercial plans and Medicaid vary by state, leaving many Americans at risk.6 The Safe Step Act (H.R. 2163/S. 464) has been introduced with the intent of standardizing step therapy protections nationwide.2 If approved, insurance agencies would be obligated to implement transparent processes for step therapy exceptions.4

Although the generalizability of our study is limited by its selfreported design, it calls attention to an opportunity for positive reform of our healthcare system. The Safe Step Act has the potential to improve protections for millions of Americans. We urge dermatologists to send the templated letter of support (Figure 2) to their representatives and senators.

DISCLOSURES

The authors have no conflicts of interest to declare. Regulatory: The survey was approved and implemented by the Scarring Alopecia Foundation (SAF)

REFERENCES

  1. Marks DH, Penzi LR, Ibler E, et al. The Medical and Psychosocial Associations of Alopecia: Recognizing hair loss as more than a cosmetic concern. Am J Clin Dermatol. 2019;20(2):195-200. doi:10.1007/s40257-018-0405-2.
  2. Alfonso M, Richter-Appelt H, Tosti A, et al. The psychosocial impact of hair loss among men: a multinational European study. Curr Med Res Opin. 2005;21(11):1829-1836. doi:10.1185/030079905X61820.
  3. Kitley M, Johnson H, Spooner A, et al. 27934 Unpaid insurance claims associated with the treatment of alopecia areata and lichen planopilaris. J Am Acad Dermatol. 2021;85(3):AB168. doi:10.1016/j.jaad.2021.06.686.
  4. American Academy of Dermatology Association. Step therapy. Available at: https://www.aad.org/member/advocacy/leg-conference/2021-policy-steptherapy. Accessed October 7, 2021.
  5. Gondo G, Boles J, Stone P, et al. Prevalence of utilization management policies among the psoriatic disease community: Results from the 2019 National Psoriasis Foundation Advocacy Survey. J Psoriasis Psoriatic Arthritis. 2020;5(4):178-183. doi:10.1177/2475530320956602.
  6. National Psoriasis Foundation. Step therapy legislation by state: Overview. Available at: https://www.steptherapy.com/step-therapy-legislation-by-state/. Accessed January 6, 2023.

AUTHOR CORRESPONDENCE

Maria K. Hordinsky MD hordi001@umn.edu
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