Home ultraviolet light therapy for psoriasis: why patients choose other options.

Background: Psoriasis is a common inflammatory skin condition for which office-based and home phototherapy are safe and effective treatments. However, patients who are prescribed home phototherapy devices often choose other treatment options.

Objective: To determine the reasons why patients do not purchase a home phototherapy device after it has been recommended and prescribed by their physician.

Methods: Patients who were written a prescription for a home phototherapy device but did not fill the prescription were identified and contacted by the National Biological Corporation to participate in a telephone survey consisting of 4 questions regarding why they did not pursue a prescribed home ultraviolet device and how they were currently treating their psoriasis.

Results: The most common reason for not obtaining the prescribed home phototherapy device was using a biologic agent (31%). The second and third most frequently reported reasons were "cost share too high" and "insurance will not cover" (18% and 17%, respectively), together accounting for 35%.

Limitations: The reason why patients were prescribed biologics while having an unfilled home phototherapy device prescription was not obtained.

Conclusions: Out of pocket cost is a significant barrier to home phototherapy, even to patients who are well insured.