A new scoping review led by researchers at the University of British Columbia has uncovered significant systemic barriers preventing psoriasis patients from accessing biologic therapies, highlighting concerning disparities in treatment accessibility across multiple demographic groups.
The study, examining literature up to March 2023, revealed that factors such as race, older age, socioeconomic status, rural residence, and insurance coverage significantly impact patients' ability to access biologic treatments. Particularly concerning was data from the US National Health and Wellness Survey showing that 59% of insured patients with mild-to-severe psoriasis received no treatment in the previous year.
Healthcare System Barriers
The research team, led by Vincent Wan from the University of British Columbia, identified several critical healthcare system-related obstacles. These include:
- Significant shortages of specialists
- Limited awareness among healthcare practitioners
- Absence of standardized diagnostic and treatment protocols
- Discriminatory practices affecting patient care
- Prohibitive costs of biologic therapies
Methodology and Research Scope
The investigators conducted a comprehensive analysis of studies from Embase, MEDLINE, and Web of Science databases. From an initial pool of 2,684 articles, 20 studies met the strict inclusion criteria. The research focused on:
- Cross-sectional studies evaluating perspectives of patients with moderate-to-severe psoriasis who hadn't received biologic treatments
- Healthcare provider viewpoints on prescribing biologics
- Retrospective chart reviews examining quantitative data on biologic therapy usage
Key Findings and Implications
The research team systematically categorized the barriers into five main areas:
- Prescriber-related factors
- Patient-related challenges
- Organizational obstacles
- Medicine-related issues
- External environmental factors
These findings underscore the complex interplay of factors limiting access to advanced psoriasis treatments. The study highlights the urgent need for systematic changes to improve treatment accessibility, particularly for underserved populations.
Study Limitations
The researchers acknowledged certain limitations in their analysis. The scoping review's exploratory nature precluded critical appraisal of the findings' strength across studies. Additionally, the significant heterogeneity among included studies made it impossible to quantitatively assess the impact of individual barriers.
These findings emphasize the need for targeted interventions to address disparities in psoriasis treatment access, suggesting that healthcare systems must work to eliminate both structural and socioeconomic barriers to ensure equitable access to biologic therapies.
