No insurance? Money tight? Psoriasis bad? Here are some ideas to help you find some relief.
Too many people with moderate to severe psoriasis – people for whom psoriasis is a daily problem – cannot afford most psoriasis treatments. We hear heart-breaking stories from people in this position regularly; some even cannot afford to see a dermatologist, let alone purchase treatments.
What should you do if you simply cannot afford treatment? Here are 10 strategies patients might consider when they are forced to think “outside the box” for their psoriasis treatment. Note: this is not medical advice, and we are not doctors. We’re fellow patients! So review this with a medical professional before trying this at home.
1. Check out drug company-supported Psoriasis Patient Assistance Programs, which offer free or reduced prices for prescription treatments to people who cannot afford them. Our full report on these prescription payment assistance programs includes an interview with Caroline, an uninsured psoriasis patient currently receiving more than $10,000 worth of prescription meds at NO COST to her!
2. Consider methotrexate. Methotrexate is a prescription treatment that has been around since the 1950s and is still used to treat psoriasis, arthritis (psoriatic and rheumatoid) and some cancers. It can cause serious side-effects, but has also been used safely by hundreds of thousands (maybe millions) of people. What makes methotrexate a good option for the uninsured is that it is available in generic pill form for about $25 per month. [Note: Pregnancy and methotrexate cannot mix.]
3. Consider topical steroids. Places like Walmart and Target now offer several generic topical steroids for as little as $4 per month! Topical steroids cannot be used for too long or on too much body surface area, but for your most troublesome psoriasis plaques, or patches, topical steroids can do the trick. They are time-tested and most physicians know how to prescribe them well. (We have, however, heard anecdotal reports of physicians who sometimes prescribe steroids that are more powerful than needed, and occasional reports of prescriptions for high-priced name-brand steroids when generics might suffice.) Kudos to Walmart for launching this program; here is Target’s list.
4. Tanning salons (or in certain climates, sunlight). Sunlight helps most psoriasis patients. Sun exposure to psoriasis patches usually reduces the symptoms of psoriasis, and in some patients, sunlight can completely clear a patient (but avoid sunburn, which can make psoriasis worse). Sunlight can pose challenges: some people do not live where it is regularly sunny, some psoriasis is not in bodily areas that can easily be exposed in public, and many people are busy during the daylight hours.
In these cases, ultraviolet (UV) light sessions under a doctor’s care are another great option. Many dermatologists and derm clinics offer UV light treatments (UVB or PUMA), and there are also home units (both full-body and hand-held) available. Unfortunately, many people do not live near a medical office that offers UV treatments. Also, home units can be costly (many insurers will help cover their costs), and even for those with insurance, co-pays can sometimes be a problem, as UV treatments are often three times per week, for 12 weeks or longer. That can be a lot of co-payments!
In these cases, tanning salons might be an option. While the lights emitted by tanning machines are inferior in treating psoriasis compared to natural sunlight or UV lights in medical offices, the fact remains that they can be better than nothing, and also can be affordable to some patients who cannot afford medically-supervised UV sessions. This is a controversial position and many dermatologists find tanning centers to be a net negative for our nation’s health (primarily due to the increased cancer risk and premature aging of the skin that come from excessive UV exposure). But for an uninsured patient with psoriasis, it may be worth considering, provided the price is right and you meticulously avoid burning.
Note: some dermatologists will even work with patients using commercial tanning salons to help them find the right dosing schedule, especially when a patient is uninsured or lives too far from a medical center offering UV treatments. It never hurts to ask. Bottom line: we recommend doctor-supervised UV treatments for all who can afford them, but also believe tanning salons should be an option for psoriasis patients who need them.
5. Participate in a clinical trial. Even treatments that are already approved by the U.S. Food and Drug Administration (FDA) are frequently tested further in clinical trials under close medical supervision. Such trials typically offer free meds and close medical supervision – a great deal for patients. Check out our full report on psoriasis research studies for FDA-approved treatments.
There are also many clinical trials under way of experimental psoriasis treatments. Some of these could be tomorrow’s wonder drugs. Experimental treatments can be riskier, as they have been tested in a limited number of people for a limited period of time. You are a human guinea pig, in many ways. But the treatment is free and it is under doctor supervision, so it can be a good deal. There is also the risk in many clinical trials that you will get randomly assigned to receive a “placebo” – a fake treatment. Scientists do this so they can compare if the experimental treatment is actually working, by comparing it to someone not really being treated. You can learn more about psoriasis clinical trials at our Psoriasis Treatment Research Pipeline.
6. Cancel your cable (or at least the HBO), high-speed internet, and expensive cell phone plan, stop buying cigarettes and booze, and use the savings to see a dermatologist and purchase treatments. Sometimes, you have to treat your psoriasis or psoriatic arthritis as the serious disease it is, and take drastic measures to feel better. Let’s face it: there are people who would purchase a $500 television, but who would never consider paying $500 out-of-pocket to see one of the world’s top psoriasis doctors for their condition.
That television would bring years of joy, but so would finding a breakthrough to make yourself feel better. In other words, as you consider all the items in your budget, and weigh their importance, do not leave out your health, even if you are uninsured. Sometimes, it is worth it to pay out of pocket to get the treatment you desperately need.
7. Call around to find a dermatologist who will treat you at discounted prices. When you are paying “cash” rather than using insurance, you have leverage to call dermatologists or rheumatologists and ask their prices for uninsured patients. Because doctors typically grant insurers significant discounts off the listed price of their office visits, they may be able to work with you to give you a discount as well. Just tell them your situation and get a price quote. Then call some others and compare prices.
8. Try warm baths; petroleum jelly and other cheap, over-the-counter lotions; loose, cotton clothes; and anything else to sooth your pain and discomfort. This item can sound defeatist, but it is not intended that way. Rather, this is just a reminder that we will all probably have times when our psoriasis is especially a problem, and as we seek to find effective treatments, we should not forget the time-tested methods of lessening symptoms. This is sometimes summarized as “moisturize, moisturize, moisturize.” In other words, take steps to ease your daily pain as you work to find an effective treatment regimen.
9. Longer term idea: look for a job that offers good health insurance. Everyone weighs numerous factors as they consider job options. If psoriasis is a problem for you, consider making a potential job’s health insurance coverage a priority for you. It might mean a longer commute or a smaller salary, but it could make you feel a lot better.
10. Walk into the emergency room. Just in recent days, we have heard from two uninsured psoriasis patients who are currently not receiving medical treatment. One reported that she was 80% covered with psoriasis; and the other that he has psoriatic arthritis that he said made him unable to work. If these people have no other options to secure medical treatment, they should walk into a hospital emergency room or community health clinic and seek treatment.
Psoriasis and psoriatic arthritis are serious diseases, and at some level of severity they reach the definition of deserving emergency treatment. In fact, federal law requires emergency rooms in the Medicare program (most U.S. emergency rooms) to provide emergency care to all patients regardless of the patient’s ability to pay. (Once you are “stabilized” they can transfer you elsewhere.)
Obviously, if you have just a patch of psoriasis on your elbow and a bit in your scalp, you will be laughed out of the emergency room. But as your psoriasis or psoriatic arthritis becomes debilitating, it should be taken seriously. When all else fails, it’s worth a shot.
DO YOU HAVE ADDITIONAL IDEAS for what to do if you have psoriasis or psoriatic arthritis and are uninsured? Please share them with us and we will cover them in a future article.