News & Insights
Real‑World Patterns of Requests for Oral JAK Inhibitors and Biologics for the Treatment of Atopic Dermatitis
By Ayanna Gooden-Rivoli, PharmD; Elton Teng, PharmD; Jeffrey He, PharmD, APh; Mark Shinmoto, PharmD
Advanced systemic therapies have expanded treatment options for atopic dermatitis (AD). An analysis of prior authorization (PA) requests across self‑insured employer health plans shows that real‑world prescribing patterns do not always align with guideline‑recommendations.
Although requests for biologics and oral JAK inhibitors involved patients with moderate‑to‑severe disease, approvals were underwhelming. Requests that documented prior use of multiple topical therapies—particularly both topical corticosteroids and topical calcineurin inhibitors—were more likely to be approved. In contrast, denials more commonly occurred when patient disease severity and topical treatment histories did not align with criteria developed from established guidelines and prescribing information.
These findings highlight a key opportunity for employer‑sponsored plans to promote cost-conscious care. Appropriate use and documentation of guideline‑aligned topical therapies support informed, cost‑effective progression to systemic AD treatments. When prescribing practices reflect optimized topical management, patients are better positioned for timely access to advanced therapies while plans can ensure resources are used responsibly and sustainably.
Bottom line: In real‑world practice, thoughtfully implemented and well‑documented stepwise topical therapy supports clinically appropriate, cost‑effective access to advanced atopic dermatitis treatments.
RThis analysis was presented by Ventegra’s 2025–2026 Managed Care Fellow, Ayanna Gooden-Rivoli, PharmD, in collaboration with the clinical team.
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