Undertreatment in psoriasis is a well-known issue and treatment satisfaction among those living with psoriasis is often cited as being modest at best. Yet, with a wider range of effective psoriasis treatments available than ever before, patients should be in a position to make more informed treatment decisions and raise the topic with their healthcare professionals. Read on to learn how pharma can tap into platforms with existing communities of psoriasis patients and can provide patient education that helps bridge the treatment gap.

Psoriasis Undertreatment: What is the Problem?

While getting a true picture of undertreatment is a tricky challenge, several studies carried out over the years suggest it is a very real issue among people living with psoriasis. A 2019 paper stated that “despite the current large inventory of effective treatment choices, including innovative biologics and oral therapy, undertreatment and non-treatment of psoriasis is prevalent worldwide, including in Europe and the USA.” Figures from a study cited in the paper claimed that 29.5% of people living with moderate psoriasis and 21.5% of people living with severe psoriasis were being treated with topical agents alone.

According to that study, over half of all people living with psoriasis (and 45.5% of people with psoriatic arthritis) were dissatisfied with their treatment. A more recent review of 60 studies involving over 35,000 patients states that patient satisfaction remains “modest”, noting that those treated with biologic agents showed higher satisfaction. While these studies account for only a small percentage of the research performed on the topic, the general consensus is that a treatment gap in psoriasis exists to at least some degree.

How (Reliable) Patient Education Can Help

According to an article published in the Dermatology Times, many people living with psoriasis are unaware of the possibility of attaining 100% clearance. While drugs such as biologics or adalimumab (Humira) are serious drugs and should be treated as such, greater patient awareness of the scope of treatment options available is surely required if the issue of undertreatment is going to be tackled. Furthermore, a safe and reliable source of patient education can help counter misinformation that may influence patients’ decisions, such as a case mentioned in MedPage Today of a person with total-body psoriasis refusing a biologic on the basis that his mother told him they are dangerous.

Furthermore, many patients rely on their dermatologists for treatment. While dermatologists (link: https://www.jaad.org/article/S0190-9622(20%2932826-7/fulltext text: are prescribing more biologic treatments rel:nofollow target:yes), there are still reports of many being reluctant to do so. In a roundtable discussion published earlier this year involving leading dermatologists, reasons cited for dermatologists not prescribing biologics include not wanting the hassle of explanations and safety discussions, the time involved in obtaining prior authorization, a lack of exposure to biologics during residency training, fear of an increased workflow, outdated safety concerns, and inconvenience.

“Some do not want to hassle with the explanations and safety discussions, even with all the data.”

– Jonathan Weiss, MD

While these attitudes are not necessarily representative of the majority of dermatologists, combined with a lack of patient awareness and the existence of misinformation it is not surprising that many people living with psoriasis remain undertreated and dissatisfied with their treatment.

Tackling the awareness and misinformation issues requires effective patient education. Traditionally, pharma accomplished this by providing patient materials to healthcare professionals, who would then hand these to patients. In the case of psoriasis, this seems a catch-22; after all, many dermatologists’ reluctance to prescribe innovative treatments is one of the main drivers behind the treatment gap. These doctors will hardly provide neutral education to patients. Luckily, times have changed. Across all disease and age groups, doctors are no longer the gatekeeper for patient education. But where can pharma reach psoriasis patients online? And how can pharma responsibly educate patients digitally and give them the confidence to discuss alternative treatment options with their dermatologist or seek advice from another healthcare professional?

Reaching Psoriasis Patients Through Open Digital Platforms

There are many ways to try reaching patients online. Some pharma companies fall in love with the idea of ‘owning the patient’ and try to establish their own digital offerings - with limited success (do you want to be ‘owned’?). Others have moved beyond that stage – or skipped it altogether – and, after acknowledging the challenges around user acquisition and retention, would rather would with platforms patients already use. For these platforms to succeed we see ‘openness’ as the key - in several aspects:

• Open for any psoriasis product: If you are living with psoriasis, you may well need support around a specific drug or treatment. But treatment plans change. Meaningful adoption, therefore, requires an offering to stay relevant to a patient, including after a change in treatment. It needs to work well with any product.
• Open for treatment needs beyond Psoriasis: More than half of all people living with psoriasis have comorbidities. They are looking for support around their health and only care so much which of their diseases drives a particular need. Most attempts of squeezing patients into pharma’s disease silos are doomed to fail.
• Open for continuous improvement: Different patients have wildly different needs. And with healthcare going digital, patients’ digital needs are evolving, too. Telemedicine, electronic prescriptions, and Digital Therapeutics are changing care pathways and support needs. To retain patients, offerings have to keep evolving as they learn about their needs.

Throughout eight years of developing the MyTherapy platform, we have seen more than 5 million users adopt different features and individually configure the app to work in a way that suits their daily needs. We’ve learned a lot from looking at the behavior of our users living with psoriasis. Many use the app to make sense of their treatment and want to understand what works or what could work. Most use them for non-psoriasis-related treatments, too. They need a digital tool that adapts to them – and not vice versa. Given their heterogeneity, personalization is key for these patients to turn into long-term users. And continuous improvement and evolution, as we do it through our monthly release cycle.

Achieving these high levels of adoption requires personalization and relevance. To this end, MyTherapy comprises three layers: The first layer is generic and provides functionality for anyone taking medications. The second layer is a disease-specific layer, providing specific tools and education for psoriasis (or other chronic diseases). The third layer is a product layer, where partners can provide specific support for their patient population, tailored to the specific needs of their product.

With ‘MyTherapy for Psoriasis’ we are building out the disease layer for people living with psoriasis and thereby add substantial value for our psoriasis user base. Partners can benefit through the aforementioned product modules, leveraging a highly accepted environment to support patients around treatment initiation and adherence. Beyond that, we are looking for partners to provide high-quality patient education to the entire psoriasis user base – and thereby hopefully put an end to treatment gaps.

What's next?

‘MyTherapy for Psoriasis’ will be available from fall 2021. If you are interested in taking advantage of the partnering opportunities available using ‘MyTherapy for Psoriasis’, please get in touch. ‘MyTherapy for Psoriasis’ is the second disease-specific program we are releasing, following ‘MyTherapy for MS’, with more in the pipeline, so don't hesitate to reach out if you want to join us in redefining patient support in a condition other than psoriasis or MS.