If you have psoriasis or know someone who does, we don’t have to remind you of the life-long challenges in treating and controlling this chronic skin condition.  The over 7  million Americans suffering know all too well how psoriasis impacts the physical and psychological aspects of their health…

There are five types of psoriasis.  The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells.  Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.

Psoriasis treatments falls into 4 main categories: oral medications – biologic injections – topical medications and UV phototherapy treatment at your dermatologist’s office.  Systemic medications (biologicals, also called ‘TNF inhibitors’) are often prescribed to treat psoriasis, despite the severe side effects they commonly produce, including both cancer and death.

From traditional media outlets to online advertising and the “social” channels, psoriasis is big business and “Big Pharma” knows this all too well.  Consumers are bombarded by TV commercials suggesting that you,  “ask your Dermatologist” about some “Biologic” for treating psoriasis.  Celebrity endorsements from professional golfers to models tout the benefits, as the potential side-effects and “risks” are quickly mentioned to conclude the high cost national spot.

Pharmaceutical companies have produced wonderful drugs for decades, many save lives.  Yet when it comes to treating psoriasis  safely and effectively, phototherapy  should be a first line defense.  In this age of “search and social”, patients can and should educate themselves as to whats best.  The phototherapy industry is dwarfed by “Big Pharma” companies and we can simply cant match the massive millions spent on advertising.

Yet perhaps a “light shines”at the end of the tunnel as the health insurance landscape has been altered by the passage of the “Affordable Care Act”.  Providers are now watching every dollar spent and focused on the new objective referred to as “outcome based medicine“.  Simply put, treatments and procedures that produce the best “outcome” for patients at the most effective cost will be the priority.

At the 2014 American Academy of Dermatology annual meeting in Denver, a poster by a group of concerned physicians indicate that “Phototherapy is more cost effective than Biologic injections for treating psoriasis”  –Shors A. Abstract #P8362. Presented at: AAD 2014; March 21-25, 2014; Denver.

This may not mean much to the psoriasis patient with a great insurance plan, but as co-pays skyrocket and physician fees are reduced, there may come a day when you may not be able to afford those costly prescriptions.  Its been reported that the true cost of treating with biologics can exceed $20,000 annually.  Again the patient may not be affected, but rest assured that the insurance company is keeping an eye of what the doctor recommends.

Recently, a new addition to the psoriasis prescription medications has joined the fray, Otezla from pharmaceutical giant Celgene.  Although it does not require a monthly injection, and in pill form, the cost to the insurance company averages about $2000 a month.  As with the biologics, a lanudry list of “risks” come with the convenience, such as “diarrhea, nausea, upper respiratory tract infection, tension headache, and headache. ”  According to their web site; “Otezla is associated with an increase in adverse reactions of depression

“Otezla is associated with an increase in adverse reactions of depression. In clinical
studies, some patients reported depression and suicidal behavior while taking Otezla.
Some patients stopped taking Otezla due to depression. Before starting Otezla, tell
your doctor if you have had feelings of depression, suicidal thoughts, or suicidal
behavior. Be sure to tell your doctor if any of these symptoms or other mood changes
develop or worsen during treatment with Otezla.” – Celgenecom


Back in the day, before there was a pill for every problem, informed citizens were advised to be cautious with the age old adage, “buyer beware”.  This may apply today more than ever, as health care evolves and patients as well as physicans seek to become more informed….