TY - JOUR
T1 - A Survey of Community Dermatologists Reveals the Unnecessary Impact of Trial-and-Error Behavior on the Psoriasis Biologic Treatment Paradigm
AU - Strober, Bruce
AU - Pariser, David
AU - Deren-Lewis, Ann
AU - Dickerson, Tobin J.
AU - Lebwohl, Mark
AU - Menter, Alan
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/10
Y1 - 2021/10
N2 - Introduction: In the USA, psoriasis affects approximately 3% of the population and costs more than $110 billion annually. The development of targeted biologics has revolutionized psoriasis management, but at an increasing cost. According to Joint AAD/NPF guidelines, an important need exists to identify biomarkers that can predict the appropriate biologic agent for patients. Methods: A survey of community dermatologists was developed to address (1) significant factors influencing biologic therapy utilization in psoriasis; (2) the clinical utility of a test stratifying biologic response. Results: Respondents confirmed that trial and error leads to frequent biologic switching. The survey indicated that 82% of dermatologists switch 10–30% of their patients in the first year and 98% switch intra-class for at least 50% of non-responding patients. The trial and error is due, in part, to formularies influencing the physician 77% of the time, with only 14% reporting that their first choice and the formulary alignment is greater than 75%. Compounding trial and error, 93% of the physicians report that they wait at least 12 weeks before determining non-response, in alignment with AAD/NPF guidelines. The lack of precision medicine and this trial-and-error approach result in unnecessary wasted spending and suboptimal patient outcomes. After being given an overview of Mind.Px, a dermal biomarker patch used to predict therapeutic response to a biologic class, survey participants expressed that:93% would utilize Mind.Px results to determine first-line therapy even if this differed from initial clinical choice100% would utilize Mind.Px if part of the prior authorization process98% say Mind.Px would improve patient outcomes81% reported Mind.Px would help with prior authorization process Conclusions: Surveyed dermatologists believe a test that predicts psoriasis treatment response to a class of biologic drugs would lessen trial and error, provide a tool for physicians to make more informed decisions about drug selection, improve patient outcomes, and significantly reduce wasted spending.
AB - Introduction: In the USA, psoriasis affects approximately 3% of the population and costs more than $110 billion annually. The development of targeted biologics has revolutionized psoriasis management, but at an increasing cost. According to Joint AAD/NPF guidelines, an important need exists to identify biomarkers that can predict the appropriate biologic agent for patients. Methods: A survey of community dermatologists was developed to address (1) significant factors influencing biologic therapy utilization in psoriasis; (2) the clinical utility of a test stratifying biologic response. Results: Respondents confirmed that trial and error leads to frequent biologic switching. The survey indicated that 82% of dermatologists switch 10–30% of their patients in the first year and 98% switch intra-class for at least 50% of non-responding patients. The trial and error is due, in part, to formularies influencing the physician 77% of the time, with only 14% reporting that their first choice and the formulary alignment is greater than 75%. Compounding trial and error, 93% of the physicians report that they wait at least 12 weeks before determining non-response, in alignment with AAD/NPF guidelines. The lack of precision medicine and this trial-and-error approach result in unnecessary wasted spending and suboptimal patient outcomes. After being given an overview of Mind.Px, a dermal biomarker patch used to predict therapeutic response to a biologic class, survey participants expressed that:93% would utilize Mind.Px results to determine first-line therapy even if this differed from initial clinical choice100% would utilize Mind.Px if part of the prior authorization process98% say Mind.Px would improve patient outcomes81% reported Mind.Px would help with prior authorization process Conclusions: Surveyed dermatologists believe a test that predicts psoriasis treatment response to a class of biologic drugs would lessen trial and error, provide a tool for physicians to make more informed decisions about drug selection, improve patient outcomes, and significantly reduce wasted spending.
KW - Biologic therapy
KW - Cost-effectiveness
KW - Physician survey
KW - Psoriasis
KW - Use patterns
UR - http://www.scopus.com/inward/record.url?scp=85110766883&partnerID=8YFLogxK
U2 - 10.1007/s13555-021-00573-1
DO - 10.1007/s13555-021-00573-1
M3 - Article
AN - SCOPUS:85110766883
SN - 2190-9172
VL - 11
SP - 1851
EP - 1860
JO - Dermatology and Therapy
JF - Dermatology and Therapy
IS - 5
ER -