It’s Time to Treat Alopecia Areata as a Medical Condition

Millions of Americans suffer from an autoimmune disease, and many battle more than one of the 100+ autoimmune disorders. This includes approximately 700,000 people diagnosed or affected by alopecia areata (AA) that affects all ages, both sexes, and all skin types, and yet, there are there are no FDA-approved treatments for this severe medical disorder.

AA is an autoimmune disease that causes serious, life-long physical and mental health challenges for patients, and putting patients first is critical when it comes treatments and coverage. Classifying AA as “purely cosmetic” diminishes the suffering and lessens the importance of treatment options and providing coverage for treatments, adding yet another access barrier for autoimmune patients. Similar dermatology conditions -- including atopic dermatitis, eczema, psoriasis, and rosacea -- are specifically listed as non-cosmetic by the Centers for Medicare & Medicaid Services (CMS), and drugs that are approved by the FDA to treat these conditions are expressly covered by Medicare Part D. CMS must list any future FDA approved treatments for AA as non-cosmetic, and health plans and PBMs should provide affordable access to FDA approved treatments for this serious autoimmune condition.

More must be done to reduce access barriers for patients with autoimmune diseases including those with AA. A recent white paper by Xcenda offers meaningful solutions for AA patients:

  • Recognize AA as a reoccurring autoimmune condition and not just cosmetic

  • Ensure patient access to doctor-recommended medicines and treatments

    • Ensure patient access when new treatments become available

    • Avoid utilization management tools such as step therapy and prior authorization that restrict patients’ access to preferred FDA-approved treatments

  • Adopt policy and regulatory changes to ensure access and affordability 

    • Update the Medicare Part D Drug manual to include future FDA-approved AA therapies as covered Part D drugs 

    • Establish reimbursement for FDA-approved treatments for AA as medically necessary when they become available

    • Ensure that cost-sharing is affordable for patients 

  • Recognize medical challenges and doctor-driven recommendations

    • Acknowledge the long-term nature of AA and the potential for relapse

    • Capture the medical and therapeutic advances for AA in physician-developed treatment guidelines 

    • Support people with mental illness associated with AA in achieving access to affordable therapy to help manage the psychological impact of AA

Patients shouldn’t struggle with accessing medicines and new treatments for AA. It’s time to change the status quo and put patients first.

Farheena Mustafa