Payer Implications and Final Takeaways from the BE BOLD Trial

In this closing segment of the Managed Healthcare Executive Between the Lines series, Philip Mease, MD, of Swedish Medical Center, Providence St. Joseph Health, and the University of Washington, and Saakshi Khattri, MD, of the Icahn School of Medicine at Mount Sinai, wrap up their discussion of the BE BOLD trial with a look at its relevance to payers and how the data should inform treatment decisions going forward.

Dr. Khattri notes that dermatology has long benefited from a wealth of head-to-head comparisons between mechanisms of action for psoriasis, helping guide first-line systemic therapy choices, and says BE BOLD marks a welcome, if overdue, start toward that same standard in the PSA space. Looking ahead to clinical practice, she says she hopes rheumatology colleagues become aware of this head-to-head data and consider bimekizumab a reasonable first-line option, given the absence of any safety signal that would preclude its use. On balancing efficacy and safety in patient conversations, she frames it as shared decision-making shaped by each patient's individual risk tolerance, noting that active or prior inflammatory bowel disease is really the only scenario where she'd avoid the drug. Asked about the study's relevance to payers, Dr. Khattri expresses hope that head-to-head superiority data will factor into coverage decisions, while cautioning against payers dictating therapy choice outright. Dr. Mease closes by endorsing decisions grounded in efficacy and safety data, with the shared goal of matching the right drug to the right patient.