Abstract
Biologics are the most effective treatment for moderate-to-severe psoriasis. Insurance approval and need for prior authorization continue to be a barrier to care for many patients with psoriasis and psoriatic arthritis. We sought to determine whether race/ethnicity, insurance type, and provider specialty affect biologic approval times. Records from the University of Miami Health System were reviewed, and 101 patients were included. Need for a prior authorization was significantly associated with long waits (p = 2.4 × 10−5). We did not identify a significant difference in wait times between non-Hispanic Whites and non-Whites. The average wait time for biologic approval for Whites was 29.7 days and for non-Whites was 27.2 days. Biologics were approved the same day for 23.7% of HMO carriers, 11.5% of PPO carriers, 63% of Medicare carriers, and 40% of Medicaid carriers (p < 0.001). There was no difference in the biologic type prescribed based on insurance type. Medicaid (p < 0.05) and the need for prior authorization (p = 2.4 × 10−5) significantly predicted approval wait time in our multilinear regression model. Patients with Medicare had the shortest wait time with a mean of 7.3 days. Medicaid patients waited a mean of 11.3 days. Private insurance patients waited the longest, regardless of whether they had a PPO (37 days) or HMO (41.3 days).
Data availability
Raw data is available at https://data.mendeley.com/datasets/9p2p82vy22/draft?a=029c0d26-7f61-40d9-b413-0122f9561b14.
References
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Funding
Supported in part by an Alpha Omega Alpha Carolyn L. Kuckein Student Research Fellowship.
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T.V. and M.F. wrote the main manuscript text, T.V., M.F., D.L., and M.P. collected the data. T.V., M.F., A.C., F.C., and A.M. contributed to concept and design. All authors reviewed the manuscript and agreed to submission.
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Vazquez, T., Forouzandeh, M., Lin, D. et al. Insurance delays in the approval of biologic medications for patients with psoriasis and psoriatic arthritis. Arch Dermatol Res 315, 1401–1403 (2023). https://doi.org/10.1007/s00403-022-02457-6
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DOI: https://doi.org/10.1007/s00403-022-02457-6