OBJECTIVES: To evaluate the access to the prescribed treatment for Brazilian moderate-to-severe plaque psoriasis patients.

METHODS: This was a cross-sectional, observational and multicenter study enrolling Brazilian patients with moderate-to-severe plaque psoriasis. Disease severity was defined according to physician evaluation. Data were collected between December/2015 and November/2016 in 10 specialized centers. Access to the treatment was evaluated in two dimensions: (1) ways of drug acquisition and (2) level of difficulty in acquiring the drug. The first dimension comprised two questions: the first one addressed if the patient acquired the drug from public system (SUS), private insurance and/or out-of-pocket; the second one assessed if legal injunctions were used. In the second dimension, the difficulty in drug acquisition was assessed through a dichotomous response (yes/no) and respective reasons.

RESULTS: The study enrolled 188 patients, mean age at study visit and at disease onset were 48 (±13.1) and 33 (±16) years respectively. Most of them were female (52.1%), Caucasian/white (68.6%) and marriage/stable union (61.7%). 45/145 (31%) patients reported psoriatic arthritis (PsA) concomitantly. The ways of drug acquisition were: through SUS and out-of-pocket (72/187; 38.5%); totally out-of-pocket (67/187; 35.8%); totally through SUS (37/187; 19.8%); totally through private insurance (2/187; 1.1%). Among those patients with PsA concomitantly, 20/41 (48.8%) reported acquiring their drugs totally through SUS and 9 (22.0%) through SUS and out-of-pocket. 12.8% (24/187) of patients reported having used legal injunction to obtain the prescribed treatment. 65/187 (34.8%) patients reported difficulty in obtaining these drugs regardless the ways of access. Among those who reported any difficulties (n=65), the drug unavailability (43.1%) and financial problems (38.5%) were the most frequent issues.

CONCLUSIONS: These study pointed out several aspects of access in Brazil: poor drug coverage for moderate-to-severe plaque psoriasis patients; use of legal injunctions to drug access; drug shortage and financial difficulties faced by these patients.