How Do I Use a Specialty Pharmacy for Psoriasis Medication? A Q&A with Dr. Truong
This article is part of a Q&A series in which a healthcare professional in our community answers your frequently asked questions.
We asked: “My dermatologist prescribed a biologic for my psoriasis. Why can’t I fill this prescription through my regular pharmacy? What steps do I need to take to get access to the medication?”
Allison Truong, M.D.: If you have moderate to severe plaque psoriasis, your dermatologist might recommend a specialty medicine to help treat it, such as a biologic. Examples of biologics used to treat psoriasis include Enbrel (etanercept), Humira (adalimumab), and Remicade (infliximab), among others.
Biologics are a targeted type of systemic drug, meaning they inhibit specific parts of your immune system to slow down disease activity. When used to treat psoriatic disease, biologics block the proteins that play a major role in the development of psoriasis and psoriatic arthritis. Most often, biologics are given by subcutaneous (under the skin) injections or by intravenous (IV) infusions.
Specialty medications like biologics need special handling, storage, and administration. That’s why you typically won’t find these types of specialty drugs at your local retail pharmacy, which typically fills more common prescriptions like topical creams, cholesterol medications, or antibiotics.
Specialty medicines are often expensive—biologics can cost $5,000 to $20,000 per dose—and require prior authorization from your insurance company. To get approved, you and your doctor must submit paperwork, bloodwork, and test results.
Once you’re approved for a specialty medicine, your health insurance company will tell you which specialty pharmacy you must use to fill your psoriasis prescription. Each insurance company chooses the specialty pharmacy it works with, so you won’t be able to choose.
The specialty pharmacy will then fill your prescription when you need it. The specialty pharmacy is in charge of getting you your psoriasis medication and seeing that it’s delivered in a timely manner. The medication may be shipped directly to your home, your doctor’s office, or sometimes, a local pharmacy.
If you’re having trouble covering out-of-pocket costs for these drugs, you do have some options. Drug manufacturers realize that specialty medicines are expensive and may provide copay assistance cards, which can help reduce the cost to you. However, you may not be eligible for copay assistance cards if you’re on a government healthcare plan, such as Medicare.
Often, your doctor’s office or the psoriasis specialty pharmacy can direct you to different foundations that may be able to assist you if you need help with paying high out-of-pocket copays.
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