By: Matt Werbach
In 2018, when psoriasis lesions began to show on Seritta Frazee’s face, she decided it was time to take her disease seriously and to find the right treatment. Before then, she’d gotten away with covering her skin, but no one wants to live life in a ski mask.
With some other diseases or conditions, the road is a little easier. You go to the health care provider, you get your diagnosis, and you begin treatment that hopefully sends you on a path to wellness or sufficient disease management. As many with moderate to severe psoriasis or psoriatic arthritis know all too well, when the treatments you need are high-priced systemics – including today’s most effective biologics – the journey to appropriate treatment is rarely ever so linear.
To list out every step of the journey Frazee has taken over the last seven years would take several pages. She has had to navigate a series of hurdles and redirections that sadly, are quite common to folks living with psoriatic disease or other chronic conditions.
While waiting several weeks for an opening at her dermatologist, Frazee was left to manage her disease with topicals not meant to address the psoriasis on her face – a high-impact site that requires different treatment. When she did finally see a specialist, she was prescribed methotrexate. This drug was once the standard of care for severe psoriatic disease, but today we have many highly effective systemics with less impactful side effects. Methotrexate also requires regular bloodwork to monitor liver health, which isn’t the case with many other treatment options. Ultimately, Frazee went on the medication, but not without reservations.
“At the age of 23, I was faced with the medical decision to be prescribed methotrexate, an effective psoriasis medication with a laundry list of risks and side effects,” Frazee shared. “I was required to sign a formal consent, due to my age as a child-bearing female. I felt in that moment a feeling of, ‘Oh my goodness, what did I just do?’ because I knew that even though that decision would be beneficial for my psoriasis in that moment, the long-term effects would always be in the back of my mind.”
A First Look at Step Therapy
When Frazee moved from marketplace to employer-sponsored health insurance, she again had to work her way through a new provider and several treatment options. This time, she experienced step therapy, as her insurer insisted on a potent steroidal topical and light therapy despite the prescription for a biologic.
Next, she was asked to go back on methotrexate before potentially gaining access to her prescribed biologic. This time, the methotrexate didn’t work. One more failure on the “try and fail” journey so common to those who experience step therapy for any disease or condition. Of course, Frazee’s psoriatic disease continued to progress during the months of delays. She was left with insufficient treatment. She decided she had no choice but to hide her psoriasis with long sleeves despite living in the hot and humid Florida climate.
The Pandemic Deals Another Blow
After failing several insurer-preferred options, Frazee was finally able to fill her biologic prescription at a specialty pharmacy and have it covered by her insurance. Then life intervened again.
Like millions of others, Frazee lost her employment because of the COVID-19 pandemic and had to find new insurance. [1] Her new plan took her off her medication, and she had to restart with treatments she and her provider knew were not likely to work. Frazee soon moved to Ohio, where she currently resides with her partner, Nicholas, who serves in the Army National Guard. You guessed it, she had another unfortunate journey through step therapy after the move and new insurance.
It’s Time to Pass the Safe Step Act
Just this February, Frazee was transitioning from one biologic to another when she was denied access to her prescribed medication once again. Can you imagine the frustration of this seemingly non-stop nightmare? Sadly, so many of you can totally understand and completely empathize, because you’ve been through it too.
Thanks to advocates like Frazee, the National Psoriasis Foundation (NPF) and its coalition partners are closer than ever to passing the Safe Step Act – a proposed Federal law that will protect people on employer-sponsored health plans against step therapy by creating a common-sense exceptions process.
On March 6, Frazee and dozens of other NPF advocates will take to the Hill in Washington, D.C., to meet with lawmakers to educate them on step therapy and its potentially damaging consequences.
You can get in on the action too. Help the millions of Americans living with chronic diseases by letting your legislator know you want them to pass the Safe Step Act.
