PBM advocacy wins for dermatology patients

With several wins for patient access to critical medications, the AADA continues to urge pharmacy benefit managers (PBMs) and payers to improve patient access to needed treatments and challenge payer use of step therapy, formulary changes, non-medical switching, and/or payer-mandated drug substitution.

AADA advocacy wins on behalf of members and the patients they serve include:

• Addressing Anthem’s formulary change to exclude Taltz so current patients may continue to use the medication.

• Stopping implementation of a UnitedHealth immunomodulator policy that would have limited coverage for only one immunomodulator treatment at a time.

Furthermore, the AADA opposed the Cigna-mandated non-medical switch of Cosentyx to Taltz. While Cigna eventually implemented the policy despite the AADA’s strenuous objections, the Academy continues to advocate for dermatologist access to the full compendium of available treatments.

The AADA is working with employers to educate them about different treatments for inflammatory diseases, including medications. Employers can use this information to evaluate their coverage and utilization management to ensure they support their employees’ access to dermatologic care.