Revolutionizing Skin Conditions: Cultivating Equity, Inclusion and Access

I have seen the dermatologist there and the waiting time at first was about 4 to 5 years and that’s the time when I finally got prescriptions from the physician.

– Person with Atopic Dermatitis, Hong Kong

When my hair loss reaches a certain extent of severity, it really affects my confidence, especially in various social situations, such as at work or even when just going home for the holidays. It seems like doctors are less focused on a patient’s QoL.

– Person with Alopecia Areata, Taiwan

The high cost of advance therapy actually doesn’t cause the fear and anxiety, is the assurance and the happiness they get from the outcome of the therapy. To continue treatment is the higher financial burden.

– Key Opinion Leader, Atopic Dermatitis, Singapore

I personally know people with eczema, at the same time they spent a lot of money kind of outside the medical, buying a lot other ‘creams’ from the shelves. If you total up the total cost, it is sometimes same or even more than the ‘high-cost therapies or biologics.

– Person with Atopic Dermatitis, Singapore

I hope the treatment will help me resume a normal life, social life included. The reason for paying a large sum for the treatment is to return to the life when I didn’t have the disease. So yes, QoL [is my goal].

– Person with Atopic Dermatitis, Hong Kong

The evaluation of new drugs or treatments tends to focus on three aspects – efficacy, safety, and cost-effectiveness. If this treatment can provide a high value, as well as being a breakthrough treatment with no existing alternatives, perhaps this process can be expedited so that the treatment is available sooner.

– Payer, Hong Kong

A Biopsychosocial Approach Improves Outcomes for Skin Conditions

As validated in our interviews with individuals living with skin conditions, patients treated with one standardized set of clinical guidelines can experience completely different outcomes due to the psychosomatic nature of dermatology conditions. Biopsychosocial stressors can create a loss of sense-of-self and isolation, affecting various aspects of their social, occupational, and emotional function and overall health-related QoL (HRQoL).

The finding argues that there is a need for more engagement and a formalized pathway that addresses the biopsychosocial nature of dermatology conditions and the support necessary across the full cycle of care.

Invest In Capacity For Coordinated Dermatology Care, Enhancing Healthcare Competency

Despite the availability of validated diagnostic and monitoring psychosocial tools and assessments, not all physicians utilize them consistently.

Investments in program building and care coordination among health administrators and care teams provide an opportunity to explore the depth and breadth of the psychosocial implications of skin disease and promote integrated care for a condition that have multifactorial triggers, with special awareness to broaden access in outpatient settings, and to those experiencing barriers in accessing care.

Chronic Dermatology Conditions Warrant Quality, Affordable Care Like Other Health Needs

Stringent criteria for reimbursement eligibility present significant hurdles through current reimbursement frameworks in Hong Kong, Singapore and Taiwan. This can cause delays in getting the treatment option that the patient may feel works better and enable them to lead normal lives (thus improving productivity and QoL). Current reimbursement frameworks also do not include coverage for psychosomatic comorbidities that may require support from a psychologist or psychiatrist.

Health financing reform for skin conditions should facilitate the non-linear availability of treatment options and comprehensive coverage of clinical and ancillary dermatology services and procedures so that individuals can have earlier access to advanced therapies to help them better manage their psychosomatic triggers and psychosocial comorbidities.

Conditions That Are Biopsychosocial In Nature Require Whole-of-society Support

Initiatives to promote better integration of care should start from an understanding of the patient’s perspective, focusing on personalized care planning and care coordination rather than organizational integration. Patients should be invited to help redesign these systems.

Governments should look at integrating the views of patients living with dermatology conditions through patient groups and civil societies when reforming national approaches to provide equitable and quality access to care.

Most importantly, civil societies provide a platform to help collect valuable insights into patient experiences, which can drive quality improvement initiatives and innovations and lead to more effective and person-centered care plans.