Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;315(4):1029-1031.
doi: 10.1007/s00403-022-02410-7. Epub 2022 Oct 28.

Equity in the usage of biologics for psoriasis in the working poor

Sarah J Eley  1 , Dustin P DeMeo  2 , Neil J Korman  3   4 , Bryan T Carroll  3   4
Affiliations

Equity in the usage of biologics for psoriasis in the working poor

Sarah J Eley et al. Arch Dermatol Res. 2023 May.

Abstract

Biologic therapy often produces excellent outcomes for psoriasis; however, their high cost may create a barrier to appropriate usage, especially in the working poor population. This study defines working poor as income below 150% of the federal poverty level and holding or seeking work at least half a year. Our study aims to identify gaps in access to biologic therapy for psoriasis based on working poor status. This retrospective cross-sectional study was conducted utilizing data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2018. Patients were stratified into working poor (57,091), non-working poor (43,421), and non-poor (693,841) groups for analysis. In univariate analysis, WP (4.0%, ph p = 0.003) and NWP (2.8%, ph p = 0.006) were less likely to use biologics than NP (15.8%) (X2 p < 0.001). A binary logistic regression showed that WP vs. NP status (OR 0.27, p = 0.05), female vs. male sex (OR 0.55, p = 0.05), Black vs. White race (OR 0.14, p = 0.02), and Medicare vs. private insurance (OR 0.09, p = 0.03) had lower odds of using biologics. After correcting for age, sex, race, and insurance, WP confers an independent risk factor to lower biologic prescriptions. The high cost of biologics in the setting of financial barriers for some patients should be considered by physicians prescribing biologic therapy for psoriasis.

Keywords: Biologics; Equity; Psoriasis; Socioeconomics; Working poor.

PubMed Disclaimer

References

    1. A profile of the working poor, 2018 : BLS Reports: U.S. Bureau of Labor Statistics. Accessed April 10, 2021. https://www.bls.gov/opub/reports/working-poor/2018/home.htm
    1. Branham DK, Conmy AB, DeLeire T, et al. Access to marketplace plans with low premiums on the federal platform. ASPE. Accessed July 10, 2021. https://aspe.hhs.gov/reports/access-marketplace-plans-low-premiums-feder...
    1. Price KN, Atluri S, Hsiao JL, Shi VY. Medicare and Medicaid spending trends for immunomodulators prescribed for dermatologic conditions. J Dermatolog Treat. Published online May 13, 2020:1–5. doi: https://doi.org/10.1080/09546634.2020.1762842 .
    1. Ross JS, Bernheim SM, Bradley EH, Teng H-M, Gallo WT (2007) Use of preventative care by the working poor in the United States. Prev Med 44(3):254–259. https://doi.org/10.1016/j.ypmed.2006.11.006 - DOI - PubMed
    1. Sbidian E, Chaimani A, Afach S, et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev. 2020;1(1):CD011535. https://doi.org/10.1002/14651858.CD011535.pub3

Substances

LinkOut - more resources