Providing Specialist Care to Psoriasis Patients

Aug 14, 2018

In recognition of Psoriasis Awareness Month, Yvonne Viteri, a senior clinical consultant at Accredo’s Rheumatoid Arthritis and Inflammatory Conditions Therapeutic Resource Center, highlights the complexity of providing care for patients with psoriasis.

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About 7.5 million Americans have been diagnosed with psoriasis, making it one of the most prevalent autoimmune diseases in the United States.

Psoriasis has a number of triggers and associated comorbidities, making it difficult for patients to manage. While psoriasis cannot be cured, several treatment options can manage it successfully, allowing patients to achieve remission. Treatments can include phototherapy, topical agents, oral agents and injectable biologics.

Specialist pharmacists and nurses at the Accredo Rheumatoid Arthritis and Inflammatory Conditions (RA&I) Therapeutic Resource Center utilize their expertise to provide drug- and disease-specific education and counseling to patients. Our unique clinical model includes:

  • Extensive patient training and education
  • Proactive therapy-effectiveness assessments
  • Assessment of daily living activities
  • Gap-in-care intervention outreach

Symptoms and Prevalence

This chronic disorder, which is characterized by redness of the skin and silver scale plaques caused by inflammation, is the result of a sped-up skin production process.

Skin cells grow deep in the skin and slowly rise to the surface before they flake off. This cycle typically takes a month, but in people with psoriasis, the process may occur in just a few days. The rapid overproduction leads to the buildup of skin cells, which don’t have time to flake off. Scales typically develop on joints, such elbows and knees, but they may develop anywhere on the body.

The National Psoriasis Foundation defines mild psoriasis as affecting less than 3 percent of the body, moderate as affecting 3 percent to 10 percent, and severe as affecting more than 10 percent of the body. Most patients with mild psoriasis can manage their condition with topical treatments. Patients with moderate to severe psoriasis, who account for nearly a quarter of people with psoriasis, require systemic therapy with oral and biologic medications.

Healthcare Impact, Importance of Specialized Care

Direct and indirect healthcare costs associated with psoriasis are estimated at $11.25 billion annually, with time away from work accounting for 40% of the indirect cost. A study published by the National Institutes of Health found that about 60% of psoriasis patients missed an average of 26 days of work a year due to their illness.

Managing psoriasis effectively is important in order for patients to have minimal or no impact to their quality of life. Biologic therapy is one of the most costly options, but it has been shown to be one of the most effective therapies for moderate to severe psoriasis. The biologic options for treating psoriasis include Cimzia® (certolizumab pegol), Cosentyx® (secukinumab), Enbrel® (etanercept), Humira® (adalimumab), Ilumya™ (tildrakizumab-asmn), Remicade® (infliximab), Siliq™ (brodalumab), Stelara® (ustekinumab), Taltz® (ixekizumab), and Tremfya® (guselkumab).

To ensure the cost-effectiveness and maximum benefit of biologic therapy, patients must understand the importance of remaining adherent to their medications. Through Accredo’s  Specialty Clinical Care Management program, specialized nurses provide extensive education to patients, teaching them how long it will take to see an effect from therapy, what side effects to expect, how to self-administer their medication  and how to store their medication.

We partner with patients through our continuous interaction to keep them engaged and adherent to their therapy. In addition, we ask patients disease-specific questions to determine the severity of their psoriasis and its impact to their quality of life. This helps us understand individual disease control and act when there is evidence that intervention could improve disease outcomes.

Psoriasis can be challenging to get under control, but remission can be achieved, thanks to the therapy options available and specialized patient care from the Accredo Rheumatoid Arthritis and Inflammatory Conditions Therapeutic Resource Center.

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