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‘Physicians need more discretion to use biologic drugs for psoriasis’
  • By Lee Hye-seon
  • Published 2018.10.29 16:50
  • Updated 2018.10.29 16:50
  • comments 0

The government should amend the healthcare system to use more biologic medications to treat psoriasis, one of the autoimmune diseases, an expert said.

Song Hae-jun, president of the Korean Society for Psoriasis (KSP), said physicians should have more discretion to use biologic drugs, at a news conference at the Plaza Seoul on Monday, celebrating the World Psoriasis Day. Song works at Korea University Guro Hospital’s dermatology department.

In detail, the government should ease physicians’ burden to prescribe a biologic medicine, instead of the standard treatment, and provide state support for educating patients about the use of biologic drugs, Song said.

Song Hae-jun, president of the Korean Society for Psoriasis, speaks during a news conference at the Plaza Seoul on Monday.

As psoriasis requires lifelong treatments, the government should consider the effective use of biologic drugs for patients, he added.

Psoriasis is a chronic skin disease, characterized by reddening of the skin and dead skin going white. It can appear on the whole body including skin, scalp, and nails. The symptoms appear and disappear repeatedly. Although it is a non-infectious disease, psoriasis patients have difficulty in social life because of the appearance of lesions on exposed areas.

Topical treatments, oral medicines, balms, phototherapies, and biologic drugs are used for the treatment of psoriasis. Biologic medicines are superior to existing drugs and have fewer side effects. However, the average cost of biologic drugs per year is about 6 million-8 million won ($5,257-$7,010), a hefty burden on patients.

Biologic medicines are covered by insurance in the following cases: If the patient has a severe chronic plaque psoriasis that lasted more than six months; if the patient has legions on 10 percent or more of the body surface area (BSA); if the patient has PASI (psoriasis severity test) score of 10 or more with moderate conditions and had no progress in methotrexate or cyclosporine treatment or a side effect occurred; or if the patient had no improvement in three months of phototherapies (PUBA or UBA), or a side effect occurred.

However, the use of biologic medicines not only raises the quality of the patient’s life but offer higher therapeutic effects, Song said. Physicians in Taiwan and Japan use two times and 10 times more biologic drugs, respectively, than those in Korea, he said.

Song went on to say that as the use of biologic drugs for psoriasis increased in Taiwan, the Taiwanese government established a committee to give hospitals approval to use biologic treatments after receiving the patient’s medical records. Patients who win the nod enjoy the full support of the state for the treatment of psoriasis.

In Japan, the government designates 500-600 medical institutions to allow the use of biologic medicines. Physicians here also have the discretion to use biologic drugs, regardless of the size of the legion, if psoriasis seriously hurts the quality of the patient’s life.

Song pointed out that the government would have to think about how to fund the snowballing cost for psoriasis, as the disease requires lifelong treatment. There are about 10 approved biologic drugs that can be used to treat psoriasis in Korea, he said.

“The government probably did not predict the growing use of biologic drugs and estimate financial costs. They should think about how to distribute the spending so that the patients in need get treatments and physicians get proper payment for medical services,” Song said.

Biologic drugs have been recently rolled out as self-administering injections, which requires a lot of explanations to the patient, Song pointed out. As Korean physicians have very short time to examine a patient and provide consultation, a prescription of a biologic drug will need extra time for explanation, he added.

“To cope with such situations, Japanese physicians receive special examination fee or ‘safe administration guidance fee’ from the government. But in Korea, doctors cannot prescribe expensive biologic drugs due to the lack of the government support,” Song said.

Patients are raising questions about why they cannot receive treatment with effective drugs. From a doctor’s point of view, this is a difficult problem, he added.

lhs@docdocdoc.co.kr

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