Treatment of Medicare Patients with Moderate-to-Severe Psoriasis who Cannot Afford Biologics or Apremilast
| Autor: | Jashin J. Wu, Jeffrey M Weinberg, Alice B. Gottlieb, Ana Maria Orbai, Jerry Bagel, Joseph F. Merola, Nicola E. Natsis |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Population Dermatology Medicare Severity of Illness Index Acitretin 030207 dermatology & venereal diseases 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Quality of life (healthcare) Psoriasis medicine Humans education Intensive care medicine Disease burden Aged Polypharmacy Biological Products education.field_of_study business.industry Arthritis Psoriatic General Medicine Phototherapy medicine.disease United States Thalidomide Quality of Life Dermatologic Agents Apremilast business medicine.drug |
| Zdroj: | American Journal of Clinical Dermatology. 21:109-117 |
| ISSN: | 1179-1888 1175-0561 |
| Popis: | Elderly patients are a group with a high frequency of psoriasis. Their disease burden has negative impacts on their quality of life. While there is a clear need to treat these patients, there are challenges in doing so. This work seeks to define the challenges that exist in treating elderly Medicare patients, as well as to provide treatment suggestions for providers to follow if they encounter one or more of these challenges. Providers face the following challenges when creating treatment plants for elderly patients with psoriasis: difficulty in obtaining drug coverage through Medicare, increased medical comorbidities, and polypharmacy. Providers aim for regimens that are affordable, safe, and efficacious, but it is not always clear how to achieve this combination, especially in elderly Medicare patients. This work is relevant in that it aims to explain the logistical roadblocks posed by Medicare coverage and provide solutions for commonly encountered issues in the treatment of a disabling and common disease in a high-risk population. Specifically, alternative treatment options to biologics and small-molecule inhibitors are discussed and include topical therapies, phototherapy, methotrexate, acitretin, and cyclosporine and for psoriatic arthritis include corticosteroids and leflunomide. The specific risks and benefits of these therapies in the elderly population are provided, allowing providers to make patient-specific decisions about optimal regimens. |
| Databáze: | OpenAIRE |
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