How Much Does It Actually Cost to Treat Psoriasis?

The realities of living with psoriasis go beyond the physical and mental symptoms of itchy and painful skin, sleep issues, and depression. Psoriasis can also have a financial impact.

Steroids and topical medications are often easier on the budget, but they don’t always work for everyone, especially if you have skin and joint involvement. On the flip side, advanced treatments such as biologics and oral medications tackle the systemic (body-wide) nature of the disease but can come with a heftier price tag. With a little careful financial planning, you can find a psoriasis treatment that works well for managing both the condition and your healthcare costs.

Getting information up front about the costs of each treatment, as well as what your insurance covers, can help you make an informed decision before your dermatologist writes the prescription. There are variations in price, even within each category of treatment.

Medication Cost and Comparison

Topical or oral corticosteroids generally cost $10 to $20 a month.

Targeted small molecule oral medications, such as apremilast (Otezla) and deucravacitinib (Sotyktu), can be pricey, says Tanya Evans, MD, a board-certified dermatologist and the medical director of the skin cancer program at the Melanoma Clinic at MemorialCare Saddleback Medical Center in Laguna Hills, California. A few treatments can run around $50,000 to $60,000 annually without insurance, she says.

Out-of-Pocket Reality

What you pay depends heavily on your insurance plan, deductible, and copays. “Out-of-pocket costs depend on the plan design,” says Dr. Evans. Some commercial plans have nearly zero out-of-pocket costs, while plans such as Medicare Part D come with higher out-of-pocket costs.

Employer or private insurance often covers biologics and oral medications but usually requires prior authorization and step therapy, which requires you to try lower-cost alternatives first. Many biologics are also offered with drug cost sharing, where you only pay a percentage of the drug cost after you meet your deductible, says Evans.

Other Direct Costs

Medication is not the only expense for people with psoriasis. Some other costs include:

• Clinical Visits and Follow-Ups These vary by region and whether you use a primary care doctor or dermatologist, says Evans. Typical specialist visit copays are $20 to $50.
• Labs and Monitoring Some biologics require labs at the start of treatment and routine check-ins. Oral medications such as methotrexate require a liver function test and complete blood count. These tests may cost $50 to $500 out of pocket, depending on your insurance and the tests ordered. With insurance, most are significantly reduced or covered.
• Phototherapy The price can vary from $50 to $150 per session, and a full course of 20 to 30 sessions can run $1,000 to $4,500 without insurance.

There are expenses not directly related to psoriasis medication that can affect your overall budget. These can include:

• Psoriasis-Related Conditions People with psoriasis can develop other conditions, such as anxiety, cardiovascular disease, depression, diabetes, or psoriatic arthritis. These related complications result in a higher financial burden, due to more doctor’s appointments and medications.

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• Skin Care Psoriasis requires a vigilant skin-care routine. Hydrocortisone, soothing moisturizers, and specialty shampoos are just some of the products dermatologists may recommend, and the costs can add up.
• Travel and Time Expenses The right doctor for you isn’t always around the corner, and taking time off work to travel to appointments can cost you.

Before you start a new treatment, it’s important to be aware of financial options to help reduce costs. Here’s what you can do:

• Ask for an estimate. Your medical office can provide an estimate of your out-of-pocket costs for treatment before the prescription is submitted.
• Check Medicare options. If you are insured by Medicare, check if the biologic is billed under medical benefit (infusion) or pharmacy (injectable).

You can also look for options outside your insurance company. Here are some to consider:

• Copay Cards or Savings Programs People with commercial insurance may qualify for programs that lower monthly costs to as little as zero to $25, if eligible.
• Patient Assistance Programs Income-based programs can help people who are uninsured or underinsured. Your clinic’s financial team can assist with applications. You can also search for the medication at NeedyMeds to see if the manufacturer offers any financial assistance or visit Dispensary of Hope.
• Manufacturer Discounts Some drug companies offer savings directly to eligible people, says Evans. Start by checking the medication’s official website or asking your doctor’s office to run a benefits investigation.
• Insurance Appeals Prior-authorization denials can often be appealed. Dermatologists may submit a peer-to-peer review or medical necessity letter when previous treatment failure or intolerance is documented, Evans says.
• Biosimilars Lower-cost biosimilars are available for some biologics, including tumor necrosis factor inhibitors. If an option exists, switching may reduce out-of-pocket costs.
• Financial Counseling Many clinics offer access to financial counselors, who can help identify cost-saving options and assist with enrollment.
• FSAs and HSAs Flexible spending accounts (FSA) and health savings accounts (HSA) can help cover copays and medications that aren’t fully covered.
• National Resources The National Psoriasis Foundation has a centralized list of financial assistance and support resources for people with psoriasis.

• Psoriasis medications are pricey and can add up to tens of thousands of dollars annually, but there are ways to reduce your out-of-pocket costs.
• Choosing the right treatment for psoriasis involves finding not only the most effective, but also the most affordable, medication.
• Doing a little research to find assistance through the drug manufacturer or enlisting the help of your clinic’s financial team may relieve some of the financial burden.