34706 An exploration in racial disparities in access to biologic treatment for psoriasis: The experience of a single academic dermatology practice

Abstract

Introduction: Psoriasis affects 7.5 million people in the U.S., with severe subtypes more prevalent in non-Caucasians compared with Caucasians. African Americans are less likely to receive biologics. More specifically, among those with Medicare, African Americans are 70% less likely to receive biologics. Similar findings are seen among Hispanics, who are less likely to receive certain biologics compared with non-Hispanics. Objective: Our primary objective is to assess if there is a disparity in access to biologics for the treatment of psoriasis in African Americans compared with Caucasian and if so, to identify whether the disparity is related to insurance status or a specific biologic. Methods: This retrospective cohort study identified patients with a psoriasis diagnosis from 2016-2020. Patient race/ethnicity, insurance status, and treatment history was collected and evaluated. Results: Of 2245 patients, 81% were Caucasian and 61% were female. Males were more likely to be on a biologic. There was no significant difference between access to biologics and race or between insurance status and biologic access. Caucasians were more likely to receive more than one biologic compared with African Americans. Conclusions: Sample size differences between this study and previous studies may explain the lack of significance in percentage of African Americans and Caucasians on biologics. The percentage of Medicare patients on a biologic is consistent with other studies. Caucasian patients were three times more likely to have received more than one biologic compared with African American patients, possibly related to predominance in this cohort.