Abstract：
Melasma and post-inflammatory hyperpigmentation (PIH) are common cosmetic dermatologic conditions that predominantly affect patients with skin phototypes III-VI. Comparing treatment coverage for these pigmentary disorders to treatment coverage for acne vulgaris may demonstrate disparities in insurance coverage for diseases that primarily affect patients of color.
Describe differences in Medicaid coverage for topical tretinoin for melasma and PIH vs. acne vulgaris in all 50 states and the District of Columbia.
This is a cross-sectional study of Medicaid insurance plans in all 50 states and the District of Columbia conducted between February 1 and 28, 2023. Data was collected from online publicly available preferred drug lists, prior authorization criteria, and email/telephone inquiries. Information was collected regarding coverage restrictions, including age restrictions, diagnostic restrictions, preferred drug status, and prior authorization requirements.
Complete coverage data for all three clinical indications was retrieved from 30 (58.8%) states; partial coverage data for acne vulgaris was retrieved from 16 (31.4%) states; no coverage data was retrieved from 5 (9.8%) states. Of states reporting coverage data, topical tretinoin is covered in 45 (97.8%) states for acne vulgaris and 10 (33.3%) states for melasma and post-inflammatory hyperpigmentation. There was decreased Medicaid coverage of topical tretinoin for acne vulgaris compared to melasma and PIH (P<0.05). Conclusion: There is differential Medicaid coverage for acne vulgaris compared to pigmentary disorders which disproportionately affect patients of color. Greater advocacy is required to ensure equal treatment for conditions that affect racial minority patients. J Drugs Dermatol. 2024;23(6):e151-e153. doi:10.36849/JDD.8069e .
Describe differences in Medicaid coverage for topical tretinoin for melasma and PIH vs. acne vulgaris in all 50 states and the District of Columbia.
This is a cross-sectional study of Medicaid insurance plans in all 50 states and the District of Columbia conducted between February 1 and 28, 2023. Data was collected from online publicly available preferred drug lists, prior authorization criteria, and email/telephone inquiries. Information was collected regarding coverage restrictions, including age restrictions, diagnostic restrictions, preferred drug status, and prior authorization requirements.
Complete coverage data for all three clinical indications was retrieved from 30 (58.8%) states; partial coverage data for acne vulgaris was retrieved from 16 (31.4%) states; no coverage data was retrieved from 5 (9.8%) states. Of states reporting coverage data, topical tretinoin is covered in 45 (97.8%) states for acne vulgaris and 10 (33.3%) states for melasma and post-inflammatory hyperpigmentation. There was decreased Medicaid coverage of topical tretinoin for acne vulgaris compared to melasma and PIH (P<0.05). Conclusion: There is differential Medicaid coverage for acne vulgaris compared to pigmentary disorders which disproportionately affect patients of color. Greater advocacy is required to ensure equal treatment for conditions that affect racial minority patients. J Drugs Dermatol. 2024;23(6):e151-e153. doi:10.36849/JDD.8069e .
摘要：
背景：黄褐斑和炎症后色素沉着过度（PIH）是常见的美容皮肤病，主要影响皮肤光型III-VI患者。将这些色素性疾病的治疗承保范围与寻常痤疮的治疗承保范围进行比较，可能表明主要影响有色患者的疾病的保险承保范围存在差异。
目的：描述黑斑病和PIH的局部维甲酸的医疗补助覆盖率与所有50个州和哥伦比亚特区的寻常痤疮。
方法：这是一项针对2023年2月1日至28日在所有50个州和哥伦比亚特区进行的医疗补助保险计划的横断面研究。数据是从网上公开的首选药物清单中收集的，事先授权标准，电子邮件/电话查询。收集了有关承保限制的信息，包括年龄限制,诊断限制,首选药物状态，和事先授权要求。
结果：从30个（58.8%）州检索到所有三个临床适应症的完整覆盖数据；从16个（31.4%）州检索到寻常痤疮的部分覆盖数据；从5个（9.8%）州没有检索到覆盖数据。在报告覆盖率数据的州中，外用维甲酸在寻常痤疮中有45种（97.8％）状态，在黑斑病和炎症后色素沉着中有10种（33.3％）状态。与黄褐斑和PIH相比，寻常痤疮的局部维甲酸的医疗补助覆盖率降低（P＆lt;0.05）。结论：与色素性疾病相比，寻常痤疮的医疗补助覆盖率有所不同，色素性疾病会不成比例地影响患者的颜色。需要加大宣传力度，以确保对影响少数种族患者的疾病给予平等待遇。J药物Dermatol.2024；23（6）：e151-e153。doi:10.36849/JDD.8069e.
目的：描述黑斑病和PIH的局部维甲酸的医疗补助覆盖率与所有50个州和哥伦比亚特区的寻常痤疮。
方法：这是一项针对2023年2月1日至28日在所有50个州和哥伦比亚特区进行的医疗补助保险计划的横断面研究。数据是从网上公开的首选药物清单中收集的，事先授权标准，电子邮件/电话查询。收集了有关承保限制的信息，包括年龄限制,诊断限制,首选药物状态，和事先授权要求。
结果：从30个（58.8%）州检索到所有三个临床适应症的完整覆盖数据；从16个（31.4%）州检索到寻常痤疮的部分覆盖数据；从5个（9.8%）州没有检索到覆盖数据。在报告覆盖率数据的州中，外用维甲酸在寻常痤疮中有45种（97.8％）状态，在黑斑病和炎症后色素沉着中有10种（33.3％）状态。与黄褐斑和PIH相比，寻常痤疮的局部维甲酸的医疗补助覆盖率降低（P＆lt;0.05）。结论：与色素性疾病相比，寻常痤疮的医疗补助覆盖率有所不同，色素性疾病会不成比例地影响患者的颜色。需要加大宣传力度，以确保对影响少数种族患者的疾病给予平等待遇。J药物Dermatol.2024；23（6）：e151-e153。doi:10.36849/JDD.8069e.
