Promoting Equitable Care Among Patients With Atopic Dermatitis

Key Takeaways:

• Disparities in care are related to patient location and health insurance: Primary gaps in care for patients with atopic dermatitis (AD) include delayed diagnosis and referral, access disparities, and coverage limitations.
• Promoting equitable care relies on deliberate provider and payer policies: Strategies which could reduce these gaps and improve health equity include telehealth platforms and other digital tools, provider incentives, improved clinical education, and expanded insurance coverage.
• Innovations in AD treatment improve disease management: Newer treatments for AD are safer and more effective than older therapies, and emerging regimens that target mechanism of action show promise in achieving durable responses with less frequent dosing.

AD affects approximately 220 million people globally. In the US, it impacted nearly 9.2 million children and 19.8 million adults in 2024.

Although significant advances have been made in the AD treatment landscape, there is still room for further improvement.

In November 2025, the Academy of Managed Care Pharmacy (AMCP) Market Insights held a virtual panel of expert managed care stakeholders to discuss the patient experience and current treatments for moderate to severe AD. The panel featured a dermatologist, health insurance representatives, an integrated delivery network, a specialty pharmacy, and a patient advocacy organization.

The conversation covered a range of topics, from gaps in access and care to current and emerging treatments for AD to suggestions for promoting health equity.

Health Disparities

According to the panelists, main gaps in care include delayed diagnosis and referral as well as limited access to dermatology specialists. Often, patients with moderate to severe AD are first prescribed a low-intensity therapy and only referred to a specialist after this treatment proves ineffective. Distance from dermatology specialists may further delay treatment initiation.

In addition, access and coverage can influence treatment adherence and patient outcomes. When a patient has to switch therapies due to coverage, that could have a negative impact on treatment adherence. Furthermore, restricted coverage limits the therapies available to patients, possibly affecting health outcomes.

Improving Health Equity

The panelists emphasized the importance of physician-patient communication during treatment decision-making. They also suggested provider incentives and education, expanded coverage criteria, and automatic prior authorization as strategies to improve timeliness of care and to reduce administrative burden.

Telehealth platforms could also help improve health equity among patients with moderate to severe AD. Tele-dermatology could expand access to patients living in rural areas who must travel longer distances to meet with a specialist.

Other digital tools such as artificial intelligence, wearable monitors, and apps might increase patient-specific data acquisition and improve disease monitoring. In addition, apps and other mediums could allow for enhanced communication between physicians and providers, increasing patient engagement.

The AD Treatment Landscape

Treatment for moderate to severe AD used to include immunosuppressants like methotrexate, cyclosporine, and azathioprine, which had limited efficacy and were associated with adverse conditions such as kidney and bone marrow toxicities, malignancies, and death.

Recently approved therapies such as corticosteroids and Janus kinase (JAK) inhibitors have demonstrated improved efficacy and better safety profiles, but they are still long-term treatments that can lead to residual disease.

Emerging treatments like OX40 and OX40L inhibitors have displayed durable responses with less frequent dosing, but payers are waiting for more data on their long-term effectiveness and safety and real-world outcomes before considering coverage.

Implications for Managed Care

The panelists provided an overview of the experience of patients living with moderate to severe AD, described the health and economic burden of disease, and outlined gaps in care and access. They suggested multiple strategies for providers and payers to reduce this burden and promote equitable care.

As the AD treatment landscape continues to evolve, collaboration among payers, providers, patients, and other stakeholders will be essential to improve timely access to effective therapies, reduce barriers to care, and promote more equitable outcomes.

Reference

Flavin B, Wolff D, Abdo M, et al. AMCP Market Insights: beyond skin deep on the role of managed care in moderate to severe atopic dermatitis. J Manage Care Specialty Pharm. 2026;32(5-b):S1-S9. doi:10.18553/jmcp.2026.32.5-b.s1