In terms of cost, Dr. Korman says it can be difficult to get insurers to cover these medications.
“It’s hard for all of them. It varies from location to location and the kind of insurance your patients have. The drugs are all very expensive, and you have to go through a lot of steps to get them. But for the people you’re able to succeed with, it can help them enormously.”
Dr. Korman points to two other new biologics on the horizon: guselkumab (J&J) and tildrakizumab (Sun Pharmaceutical). Both are IL-23 inhibitors and currently in phase 3 trials, Dr. Korman says.
Two other IL-17 inhibitors, ixekizumab (Eli Lilly) and brodalumab (Valeant), are awaiting FDA approval. Studies of ixekizumab and brodalumab suggest 70% of patients could reach levels of at least 90% improvement.
Why are the new drugs important if they only may modestly improve on the existing medications? Dr. Korman says it’s crucial to develop more options for patients.
“I have plenty of people currently who have seen seven different drugs, and none of them work really well: They have side effects or their insurance won’t pay for it. They’re waiting for the eighth. That’s the value that is added.”
In the big picture, Dr. Korman says, the current and upcoming drugs offer the prospect of remarkable improvement.
“People will tell you stories about how ‘I now wear shorts, I never wore shorts in my entire life.’ Or ‘I got married. Before, I had psoriasis in my private area, I never wanted anyone to see that. Now, I feel more confident, more willing to function in the world.’ It can change their lives.”
Disclosure: Dr. Korman has been an investigator, consultant, advisor, and/or speaker for AbbVie, Amgen, Celgene, Chugai Pharmaceutical Co., Eli Lilly , Janssen, Merck, Novartis, and Pfizer.