Specialty Medication Adherence Lags as Half of Eczema Patients Skip Prescriptions

In relays, the exchange zones—brief moments where one runner hands the baton to another—can make or break the race. The track from prescribed to persistent is similar, with multiple hand-off points that, if fumbled, impact specialty medication adherence. For Eczema Awareness Month, take a closer look at how information gaps at critical moments impact patients diagnosed with atopic dermatitis (AD), the most common form of eczema.

Why Is Specialty Medication Adherence Under Pressure in Dermatology?

Specialty medication adherence is under pressure because dermatology prescribing volume is growing faster than the prescribing infrastructure built to carry patients from first fill through ongoing adherence.

In the past decade, many specialty medications have been developed to relieve and manage AD, psoriasis, and other chronic skin conditions. That should be good news for more than 6 million patients diagnosed with moderate to severe AD. A study published by Journal of the American Academy of Dermatology earlier this year found that the number of biologics prescribed by dermatologists to Medicare Part D beneficiaries increased from 23% to 44% between 2018 and 2023.

High-Cost Specialty Meds Trigger Hand-Off Challenges

Increased prescribing of these specialty medications has led to growth in Medicare dermatology spending from $768 million in 2013 to $2.95 billion in 2022, according to a JAMA Dermatology article. What’s more, nearly 70% of that spending growth is tied to just seven therapies introduced since 2013.

How does this impact providers and patients?

It means more prescriptions than ever are delayed or abandoned. Once a physician selects a drug, poor visibility into real-time benefits, prior authorization requirements, or specialty pharmacy routing can result in pharmacy bounce-backs and rework that delay the script. Meanwhile, a patient's concerns about a new therapy and its affordability can put the brakes on fill rates and adherence. The American Journal of Managed Care reports that about half of insured patients diagnosed with AD filled no related prescription in 2023.

That gap is driving concern around specialty medication adherence in dermatology. Biologics can bring patients relief, but only if the prescribing workflow and patient onboarding run smoothly.

What Long-Term Biologic Data Can Tell Brand Teams

A registry study published in JAMA Dermatology, following more than 1,200 patients on a widely used eczema biologic across a five-year span, found strong real-world effectiveness. It also found that nearly one in four patients stopped treatment within about a year, usually citing side effects or a response that fell short of expectations.

That’s a finding from further down the track, showing you need downstream engagement to keep up the momentum once the script has been filled.

Where PSP Programs Still Have Room to Move

Dermatology has its own well-documented version of this friction. A peer-reviewed study in Dermatology Online Journal found prior authorization was needed for 24% of dermatology patients, with 12% of those cases ending in delayed or abandoned treatment and nearly half taking longer than a week to clear. Even with a quick PA approval, patients can encounter other barriers that slow or stop onboarding in its tracks. But when you reach providers and patients at the right moments, with the right messages, it can help increase speed-to-therapy and long-term adherence.

A prescription abandoned quietly after 48 hours looks identical on paper to one that was never going to get filled at all, which is exactly why this window is where PSP programs have the only leverage that matters.

The Geography Problem Market Access Teams Can’t Average Away

Dermatology access isn’t the same across the nation. The map has some genuinely thin patches. Specialist density for dermatology, allergy, and immunology practitioners ranges from 4.4 providers per 100,000 people in Oklahoma to 15.2 in Washington, D.C., a gap of more than threefold, according to the American Journal of Managed Care’s coverage of NEA-commissioned analysis. As specialty medicine’s share of total drug spend keeps climbing, payers have every incentive to tighten utilization management, not loosen it, which raises the stakes exactly where specialists are already scarce.

Keep Specialty Medication Adherence On Track

Relay teams rarely lose because their runners are slow. They lose because the handoffs break down under pressure, in the two or three seconds somebody wasn’t watching closely enough. Dermatology’s prescription process is failing in those moments, at a scale that’s visible in the data. Closing gaps doesn’t take a bigger awareness campaign. By improving the prescribing and patient engagement workflows with actionable insights, you can help prevent barriers to specialty medication adherence from taking your innovative therapies out of the running.