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Some Payers Remove Step Therapy Barrier for Psoriasis Treatment

Patients with plaque psoriasis and adult patients with active psoriatic arthritis who obtain their pharmacy benefit coverage from Aetna, Prime Therapeutics or select Express Scripts plans will be able to access the oral psoriasis treatment apremilast (Otezla, Celgene) without having to follow a step therapy program, according to the company. Step therapy requires patients to go through a series of steps, trying other medications and failing on them, before the insurance company will pay for another available medication that may have been prescribed by their doctor.

This decision marks a major milestone for patients who were previously required to try and “fail” on a biologic therapy prior to being prescribed the treatment. This change in procedure will ensure patients can receive, as prescribed, the right drug at the right time for their condition. The formularies officially went into effect on January 1, 2017, said Celgene.

Apremilast 30 mg tablets is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP). PDE4 inhibition results in increased intracellular cAMP levels which is thought to indirectly modulate the production of inflammatory mediators. However, the specific mechanism(s) by which OTEZLA exerts its therapeutic action in patients with plaque psoriasis or psoriatic arthritis is not well defined.

Patients with plaque psoriasis and adult patients with active psoriatic arthritis who obtain their pharmacy benefit coverage from Aetna, Prime Therapeutics or select Express Scripts plans will be able to access the oral psoriasis treatment apremilast (Otezla, Celgene) without having to follow a step therapy program, according to the company. Step therapy requires patients to go through a series of steps, trying other medications and failing on them, before the insurance company will pay for another available medication that may have been prescribed by their doctor.

This decision marks a major milestone for patients who were previously required to try and “fail” on a biologic therapy prior to being prescribed the treatment. This change in procedure will ensure patients can receive, as prescribed, the right drug at the right time for their condition. The formularies officially went into effect on January 1, 2017, said Celgene.

Apremilast 30 mg tablets is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP). PDE4 inhibition results in increased intracellular cAMP levels which is thought to indirectly modulate the production of inflammatory mediators. However, the specific mechanism(s) by which OTEZLA exerts its therapeutic action in patients with plaque psoriasis or psoriatic arthritis is not well defined.

Patients with plaque psoriasis and adult patients with active psoriatic arthritis who obtain their pharmacy benefit coverage from Aetna, Prime Therapeutics or select Express Scripts plans will be able to access the oral psoriasis treatment apremilast (Otezla, Celgene) without having to follow a step therapy program, according to the company. Step therapy requires patients to go through a series of steps, trying other medications and failing on them, before the insurance company will pay for another available medication that may have been prescribed by their doctor.

This decision marks a major milestone for patients who were previously required to try and “fail” on a biologic therapy prior to being prescribed the treatment. This change in procedure will ensure patients can receive, as prescribed, the right drug at the right time for their condition. The formularies officially went into effect on January 1, 2017, said Celgene.

Apremilast 30 mg tablets is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP). PDE4 inhibition results in increased intracellular cAMP levels which is thought to indirectly modulate the production of inflammatory mediators. However, the specific mechanism(s) by which OTEZLA exerts its therapeutic action in patients with plaque psoriasis or psoriatic arthritis is not well defined.