Trends in home phototherapy adoption in the US: Monetary disincentives are only the tip of the iceberg

Abstract

There are often multiple hurdles that must be crossed to obtain home phototherapy devices. To identify these obstacles, we examined survey data from the National Biological Corporation on patients who never acquired a home unit after being given a prescription from their doctors. Additionally, physicians' prescribing patterns were assessed from data gathered by IMS Health. Physician education of and willingness to prescribe home phototherapy was assessed via a survey distributed at the 9th Annual Dermatology Chief Residents' Meeting. When psoriasis patients were written a prescription for home phototherapy, less than half acquired a unit. Most patients (72%) stated that they did not get a unit secondarily to the high out-of-pocket expenses. In 2006, dermatologists wrote 94 385 new scripts for etanercept, compared with only 1073 scripts for home phototherapy. Very few (35%) dermatology residents receive formal training on home phototherapy. When it comes to the reasons behind patients receiving significantly more expensive biologics instead of home phototherapy for their psoriasis, high copays and deductibles are just the tip of the iceberg. It is likely that even more patients are never prescribed a home unit due to lack of physician training or frustration with meager and often inadequate reimbursements from insurance.

Key words::

• copay
• cost
• deductible
• insurance
• prescriptions
• UVB

Acknowledgement

The Center for Dermatology Research is supported by unrestricted educational grants from Galderma Laboratories, L.P. and National Biological Corporation. National Biological Corporation provided some of the survey data used in this manuscript. Dr Feldman has received research, speaking and/or consultant support from the following companies: Galderma, Connetics Corporation, Astellas, Abbott Labs, Warner Chilcott, Centocor, Amgen, Photomedex, Genentech, Biogenidec, Coria, Pharmaderm, Dermatology Foundation, American Society for Dermatologic Surgery, National Psoriasis Foundation, Ortho Pharmaceuticals, Roche Dermatology, 3M, Bristol-Myers Squibb Dermatology, and Novartis. Dr Yentzer does not have any conflicts to disclose.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.