NEA Data Highlight Persistent Access Issues in Eczema

Nearly 4 in 10 patients with eczema are encountering insurance-related barriers to care, and a notable proportion are forgoing prescribed treatment altogether, according to interim data presented by the National Eczema Association (NEA) at a February 2026 Congressional briefing.¹

The findings, shared with lawmakers and staff on Capitol Hill, suggest that despite rapid advances in the therapeutic landscape for atopic dermatitis, access to care remains inconsistent. Among surveyed patients and caregivers, 15% reported never starting a prescribed medication because of insurance issues, highlighting a persistent gap between prescribing decisions and real-world treatment initiation.

Atopic dermatitis affects more than 31 million individuals in the United States and is associated with chronic inflammation, intense pruritus, and substantial quality of life burden.² Over the past several years, dermatologists have gained access to an expanding range of therapies, including targeted biologics and oral Janus kinase inhibitors, in addition to established topical agents. These newer options have reshaped treatment expectations, particularly for patients with moderate to severe disease who previously cycled through less effective regimens.

However, the NEA data suggest that insurance design has not kept pace with therapeutic innovation.¹ Administrative requirements such as prior authorization and step therapy continue to influence whether and when patients can access prescribed medications.

The interim analysis presented at the briefing draws from the NEA’s 2025 Access to Prescription Treatment Survey, as well as prior research on out-of-pocket costs and patient treatment preferences. Nearly 40% of respondents reported experiencing at least 1 coverage-related issue within the past year. These issues ranged from outright denials to delays and unexpected cost burdens.

Treatment disruption also emerged as a recurring theme. Twelve percent of respondents indicated they had discontinued a prescribed medication due to coverage challenges. In parallel, the 15% who never initiated therapy because of insurance barriers point to a distinct access issue at the front end of care. For clinicians, this may manifest as apparent non-adherence when, in reality, patients are unable to obtain the prescribed therapy.

Step therapy and prior authorization requirements remain central contributors. Among those who encountered coverage issues, more than one-third reported being subject to step therapy protocols. In some cases, patients were required to retry medications they had previously used without success. Prior authorization requirements were even more common, affecting more than half of those with coverage challenges and continuing to serve as a major source of delay.

Insurance transitions appear to further complicate access. More than half of respondents who changed insurance plans within the past year reported new coverage issues under their new insurer. In addition, nearly 1 in 5 individuals experiencing coverage problems described confusion or miscommunication regarding coverage status or out-of-pocket costs, underscoring the administrative complexity patients must navigate.

The data were presented during a policy-focused session featuring NEA leadership, including President and CEO Kristin Belleson and Chief Program and Mission Officer Wendy Smith Begolka, alongside a patient advocate. The discussion emphasized the need for legislative and regulatory approaches to reduce administrative burden and improve continuity of care. Proposed areas of focus included limiting step therapy requirements, streamlining prior authorization processes, and increasing federal investment in dermatologic research.

For clinicians, the findings provide a reminder that treatment decisions extend beyond clinical efficacy and safety. Insurance-related delays can prolong disease activity and contribute to patient frustration, particularly in a condition where symptom control is closely tied to quality of life. The requirement to revisit previously ineffective therapies under step therapy protocols may also conflict with guideline-based care and clinician judgment.

The rate of primary non-initiation observed in the survey is especially relevant to clinical practice. When patients do not start prescribed medications, disease control may remain suboptimal, potentially leading to increased health care utilization and escalation of disease severity. Similarly, interruptions in therapy due to coverage loss or cost issues may undermine long-term management strategies.

As the treatment landscape for atopic dermatitis continues to evolve, the disconnect between available therapies and patient access remains a critical issue. While newer agents have expanded the ability to individualize care, their impact may be limited if administrative barriers persist. Aligning payer policies with current evidence and clinical practice patterns may be an important step toward improving outcomes.

In the meantime, dermatology clinicians may need to continue navigating these constraints, balancing therapeutic goals with practical considerations around access. Awareness of common insurance barriers, as well as proactive communication with patients about potential delays, may help mitigate some of the challenges highlighted by the NEA data.

References

1. Nearly 40% of eczema patients face insurance barriers, according to ne4w data presented on Capitol Hill by the National Eczema Association (NEA). News release. National Eczema Association. Published March 4, 2026. Accessed March 17, 2026. https://www.prnewswire.com/news-releases/nearly-40-of-eczema-patients-face-insurance-barriers-according-to-new-data-presented-on-capitol-hill-by-the-national-eczema-association-nea-302704343.html
2. Ali F, Vyas J, Finlay AY. Counting the burden: atopic dermatitis and health-related quality of life. Acta Derm Venereol. 2020;100(12):adv00161. Published 2020 Jun 9. doi:10.2340/00015555-3511