What are Biologics?
Biologics are medications made from living organisms or their components, like proteins or antibodies. They're designed to target specific molecules or pathways involved in diseases like rheumatoid arthritis or psoriasis. Unlike traditional drugs, which are chemically synthesized, biologics are produced through biotechnological processes in living cells. They're often used for conditions where other treatments have failed and are administered via injection or infusion.
What dermatological conditions can biologics medication help to treat?
Biologics medications are used to treat a variety of conditions, primarily autoimmune diseases and certain types of cancer. Common autoimmune diseases treated with biologics include atopic dermatitis, urticaria, and every version of psoriasis (plaque, sebopsoriasis, guttate, palmoplantar psoriasis etc.). These medications work by targeting specific molecules or pathways involved in the disease process, helping to modulate the immune system, reduce inflammation, and improve symptoms and quality of life for patients.
Commonly Prescribed Medications
Including and not limited to:
- Cosentyx®
- Taltz®
- Skyrizi®
- Tremfya®
- Ilumya®
- Humira®
- Enbrel®
- Cimzia®
- Stelara®
- Otezla®
- Sotyktu®
- Dupixent®
- Adbry®
- Rinvoq®
- Xolair®
The Prior Authorization Process
The prior authorization process for biologics medication involves obtaining approval from a patient's insurance provider before the medication can be prescribed or administered. This process typically requires the healthcare provider to submit detailed information about the patient's medical history, diagnosis, and treatment plan to the insurance company. The insurer then evaluates this information to determine if the requested medication is medically necessary and meets their coverage criteria. The prior authorization process aims to ensure that patients receive appropriate and cost-effective treatment while also managing healthcare costs for insurance providers. Once authorization is obtained, the patient can proceed with obtaining the prescribed biologics medication, often with coverage provided by their insurance plan.
Starting a Biologics medication can be overwhelming, it can be a long intimidating process. The entire process can take up to a month to complete, patients will assist in this process by bringing all documentation to your appointments, including your insurance cards and prescription drug cards. As part of our commitment to comprehensive care, patients must actively participate in medication coordination with the drug company. This involvement ensures that you have a clear understanding of your coverage, copays, and any prior authorization requirements for prescribed medications, including biologics. By working together, we can optimize your access to treatment and ensure that you receive the medications you need in a timely manner.
Biologics medications are a game changer and an essential tool for dermatologists to treat skin conditions. The insurance approval for these medications can be tricky, but our Prior Auth Specialist is dedicated to advocating for patients. Her expertise ensures that necessary treatments, like biologics medications, aren't delayed or denied unjustly. With her knowledge of insurance protocols and dedication to patient care, they adeptly navigate the prior authorization process, advocating for patients every step of the way. Brittany's commitment ensures that patients receive timely access to the treatments they need, helping to improve health outcomes and quality of life.
If you need to contact our Prior Auth Specialist Brittany, please reach out to her directly at (517) 349-9777 ext. 2206