Addressing Barriers to Medication Access for Vitiligo Therapies


Renata Block, PA-C, and Chesahna Kindred, M.D., MBA, FAAD, explain how organizations addresses barriers to medication access (co-pay cards, patient coordinators) for novel vitiligo therapies.

Dr. Heather Woolery-Lloyd: When it comes to costs, we’re talking a lot about costs right now. Renata, when it comes to your practice, how does your practice address barriers to medication access for these novel vitiligo therapies, or the novel vitiligo therapy that we’re talking about today?

Renata Block: Well, first of all, (Dr. Kindred), you stated everything so beautifully, and (Dr. Owens), you put us into a realistic environment that we are living in. I think the most important and the biggest take-home message here, (with regard) to getting these drugs approved, is that documentation. The documentation and the charge is so important. (Dr. Owens), you’re right. We have exhausted all those non-FDA-approved options, and these people already have been there, done that. Documenting the psychosocial issues that the patient has, the quality of life, their treatment durations and of course, like I said, the failures, is very important in supplying that documentation with the research (with regard) to these novel therapies. It takes a lot of time and it’s very frustrating for us as clinicians. It takes us away from patient care. That being said, it has to be done. We have to work within it. I think if you have a well-put-together note, it can make your life a lot easier to get things approved a lot faster and get the patients on the treatment that they deserve. Because in the end, like you said, (Dr. Woolery-Lloyd), this is all about the patients, right? The patient’s quality of life, the patient getting the results to make them better.

Dr. Heather Woolery-Lloyd: I agree. I think that’s a very good point. Not only quality of life, we didn’t talk about this as much, but I also would like to emphasize that vitiligo is a medical autoimmune condition. I do think sometimes that that basic understanding that this is a medical autoimmune condition can get lost when we’re seeking out access for our patients. Everyone has brought up great points. As far as co-pay cards, I definitely utilize those. (Dr. Kindred) and Renato, do you use utilize the co-pay cards for your patients all the time?

Renata Block: All the time. We go to specialty pharmacies all the time to help us get through that, but I’ll be honest with you, those have required prior authorizations with medical records as well. We’re at the point where we go to the path of least resistance to get these drugs for our patients. We want to work with pharmacies that do take these co-pay cards and allow us to prescribe what we think is best for the patient.

Dr. Heather Woolery-Lloyd: (Dr. Kindred), in your practice, do you utilize co-pay cards, or do you have a patient coordinator? How do you have things within your practice that address these barriers to our patients getting these types of medications?

Dr. Chesahna Kindred: No, we don’t use co-pay cards. It’s hard for us to keep up with them, accidentally handing out one that expired, finding which one worked for which medication. We just use specialty pharmacies that have these coupon cards on deck, and so it’s much easier and more efficient for us to have in mind the four pharmacies that have the discounted rates for the patients and send them to one of those four pharmacies.

Dr. Heather Woolery-Lloyd: Yes, I think that that’s so helpful, and you brought up this point of specialty pharmacies, which have become so important in dermatology.

Dr. Chesahna Kindred: Critical.

Dr. Heather Woolery-Lloyd: You know, specialty pharmacies didn’t exist ten years ago, and now almost every script goes to a different pharmacy depending on what the medication is. That’s a new occurrence. I love specialty pharmacies in my practice because I do think it does simplify for patients (to) have access, and it also gives them the best chance of getting the prescription that we’re writing. Thank you so much for bringing that up, because that is definitely something that we haven’t touched on too much. I think it’s really important for access for new medications.

Transcript edited for clarity.

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