Pharmacy & Therapeutics - June 2008 - (Page 365)

P&T SNAPSHOT At a Glance: Dermatology Trends In Managed Care Noah Scheinfeld, MD, John Jesitus, MA, and Peter Sonnenreich, MA Introduction In the spring of 2006, the National Association of Managed Care Physicians (NAMCP) and Galderma Laboratories, LP, surveyed almost 3,500 medical directors, pharmacy directors, and other professionals in managed care organizations (MCOs) throughout the U.S. about policies, ongoing problems, and trends relating to care in dermatology. The NAMCP and the American College of Occupational and Environmental Medicine also sent surveys to a sampling of employer representatives involved in decision-making concerning benefit coverage for corporate employees. In addition, researchers surveyed dermatologists in the U.S. about the characteristics of their practices and their relationships with managed care. This brief article summarizes selected findings from the resulting report, called The Galderma Quality Report for Dermatology & Managed Care (Volume II). This second edition of the report, published in 2007, shows that two-thirds of dermatologists surveyed used more biologic therapies for psoriasis during the previous year. In addition, nearly 70% of MCOs surveyed anticipated that dermatologists will use more biologic treatments in the future (Figure 1). The report incorporates surveys of approximately 200 dermatologists from within 3,500 MCOs, and 84 employers on topics ranging from treatment trends to payment, billing, and coding for procedures. How do you anticipate that dermatologists will use biologic treatments for psoriasis over the next year? 14.7% Formulary Forces Only 14% of dermatologists surveyed responded that they often or always followed a formulary that they believed to be overly restrictive (Figure 2). More than 50% of dermatologists also said that because of increasing direct-to-consumer marketing by pharmaceutical companies, patients are coming to their offices requesting specific medications. Managing Phototherapy In the MCO survey, more than 50% of responding organizations required prior authorization for phototherapy, which can often be used to treat psoriasis symptoms effectively. However, nearly 25% of the surveyed MCOs covered phototherapy with no prior authorization or copayments, whereas 14% required copayments and 12% offered no coverage for phototherapy (Figure 3). In response to a separate question, nearly twothirds of those surveyed indicated that they did not limit the number of office visits covered for phototherapy. Concerns of Dermatologists The survey revealed that in addition to concerns about efficacy, many dermatologists factor the amount of patients’ coHow often do you follow a formulary if you believe the formulary is restrictive? 2.4% 11.5% Never Seldom Sometimes 16.7% More Less The same Don’t know 10.7% Often Always 5.3% 42.6% 69.3% 26.8% Figure 1 Projected use of biologic therapies. (From The Galderma Quality Report for Dermatology & Managed Care, Volume II, 2007.) Dr. Scheinfeld is Assistant Professor of Dermatology at Columbia University in New York, New York. Mr. Jesitus is a medical writer based in Denver, Colorado. Mr. Sonnenreich is Executive Vice President of Kikaku America International in Washington, DC. Figure 2 Percentages of dermatologists who prescribe in accordance with formulary restrictions. (From The Galderma Quality Report for Dermatology & Managed Care, Volume II, 2007.) Disclosure: Dr. Scheinfeld has no commercial or financial relationships to report in regard to this article. John Jesitus received financial compensation from Kikaku America International for writing this article for P&T. Mr. Sonnenreich received a grant from Galderma Laboratories to create both versions of The Galderma Quality Report for Dermatology & Managed Care, for which he served as Editorial Director. Accepted for publication March 25, 2008. Vol. 33 No. 6 • June 2008 • P&T® 365

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Editorial Aliskiren Reduces Plasma Renin Activity Medication Errors Prescription: Washington New Drugs/Drug News/ New Medical Devices Drug Forecast Challenges in Evaluating and Standardizing Medical Devices in Health Care Facilities California e-Pedigree Rules Pose Challenges For Pharmacies Pharmaceutical Approval Update American Psychiatric Association At a Glance: Dermatology Trends in Managed Care

Pharmacy & Therapeutics - June 2008

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