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Advocating for Patients: Securing Access to Nonsteroidal Topicals Like Roflumilast

 RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, to discuss strategies for overcoming access challenges to non-steroidal topicals like roflumilast foam for people with plaque psoriasis (PsO) on the scalp.

In this clip, recognizing that efficacy is irrelevant without availability, Shahriari and Hartigan share key documentation and communication tips that can help clinicians and staff navigate insurance approvals more efficiently.

Hartigan emphasizes the importance of accurate, detailed documentation—including treatment area, body surface area (BSA), and prior medication history—within provider notes and prior authorizations. He notes a recent trend in payers requesting evidence of concurrent topical therapy, especially non-steroidals, for patients already on biologics. Shahriari adds that correct ICD coding and alignment with FDA indications are essential for ensuring age- and condition-specific approval.

Both highlight the growing role of specialty pharmacies in simplifying access by applying manufacturer copay programs and proactively sourcing alternative funding. They also stress the value of persistence—sharing success stories where staff-led appeals and thorough documentation reversed initial denials. Shahriari, a patient herself, reinforces the medication’s utility as a safe, simple, and steroid-free option she routinely relies on and recommends.

Lastly, they emphasize the importance of advocacy and the responsibility clinicians and coordinators have in securing the therapies their patients need.

Editor's note: The FDA approved Arcutis Biotherapeutics's roflumilast under the name Zoryve as the first foam option available for scalp psoriasis in May 2025.

Tackling Real-World Barriers in Scalp Psoriasis Treatment Delivery

Formulation Matters: Managing Scalp Psoriasis Across Hair Types

The Role of Roflumilast in Long-Term Psoriasis Management

Counseling Patients With Psoriasis on Roflumilast and Nonsteroidal Topicals

Bridging and Enhancing Biologic Response With Targeted Topicals for Scalp Psoriasis

is Assistant Clinical Professor of Dermatology at Yale University School of Medicine, the Associate Director of Clinical Trials at CCD Research and a senior editor for the Journal of Psoriasis and Psoriatic arthritis. She also hosts 

is a biologic coordinator for Optima Dermatology and the Education Chair for Biologic Coordinators of Dermatology. 

Relevant disclosures for Shahriari include AbbVie, Dermira, Cara, Dermavant, Novartis, Union, BMS, Leo, Eli Lilly, Sanofi, Regeneron, UCB, and others. Hartigan reports no relevant disclosures.

Arcutis Biotherapeutics. Arcutis’ ZORYVE® (roflumilast) Topical Foam 0.3% Approved by U.S. FDA for the Treatment of Plaque Psoriasis in Adults and Adolescents Ages 12 and Older - Arcutis Biotherapeutics. Arcutis Biotherapeutics. Published May 22, 2025. Accessed May 22, 2025. 

https://www.arcutis.com/arcutis-zoryve-roflumilast-topical-foam-0-3-approved-by-u-s-fda-for-the-treatment-of-plaque-psoriasis-in-adults-and-adolescents-ages-12-and-older/

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In this video, the last in a 6-part series, panelists discuss recent advancements in PsO management.

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The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

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Video Series

Advocating for Patients With Psoriasis: Securing Access to Nonsteroidal Topicals Like Roflumilast

 RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, to explore integrating topical roflumilast into the treatment regimens of patients on biologics, particularly for managing residual or scalp psoriasis. 

In this clip, Shahriari emphasizes that even among patients with moderate-to-severe disease on systemic therapy, topicals remain essential to maintaining long-term disease control. She outlines 3 key roles for roflumilast in biologic workflows. First, it serves as a therapeutic bridge while patients await biologic approval or navigate insurance delays. Second, for patients hesitant to initiate systemic therapy, it provides a non-steroidal, well-tolerated alternative that can manage symptoms while allowing time for decision-making. Finally, among patients already receiving biologics, tapinarof functions as a reliable adjunct for addressing breakthrough lesions—what she refers to as “touch-up paint”—helping maintain clearance and potentially delaying or avoiding unnecessary treatment switches.

She highlights the importance of minimizing disruptions in effective biologic regimens and notes that roflumilast can be safely used in combination with systemic agents, with no FDA contraindications. This flexibility allows for seamless integration into existing care plans while reducing the administrative burden on biologic coordinators and preserving therapeutic continuity.

In this video, the fifth in a 6-part series, panelists discuss recent advancements in PsO management.

 RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, to discuss patient counseling strategies and the importance of empathy when introducing new therapies such as topical roflumilast. 

In this clip, Hartigan highlights the unique role biologic coordinators play in patient education, often fielding extended conversations that reinforce provider messaging and address individual concerns about new treatments.

The discussion centers on counseling patients who are hesitant to start roflumilast due to its recent approval or skepticism from past topical treatment failures. Hartigan emphasizes that trust-building, concise communication, and reinforcing key differentiators, such as roflumilast's non-steroidal profile and favorable tolerability, are critical for improving patient acceptance and adherence. He notes that patients often ask whether the product will be effective after previous disappointments and express concerns over out-of-pocket costs.

Hartigan and Shahriari underscore that consistent messaging across the care team and validating the patient experience through empathy are essential. By acknowledging patient frustrations, reaffirming shared goals, and providing practical context around therapeutic decisions, coordinators can help ensure smoother transitions to new treatments and support long-term disease management in chronic plaque PsO.

In this video, the fourth in a 6-part series, panelists discuss recent advancements in PsO management.

 RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, explore the clinical value of a non-steroidal foam formulation in chronic plaque psoriasis management. 

In this clip, Shahriari emphasizes that tolerability is a critical determinant of adherence, as patients frequently discontinue treatments that cause burning or stinging, particularly when applied to excoriated or inflamed skin. She identifies simplicity, comfort, and consistency as essential attributes for long-term topical success.

Shahriari explains that patients increasingly seek a once-daily topical that is versatile enough for use across all body areas without risk of skin atrophy or pigment changes. She notes a growing preference in her practice for non-steroidal options like roflumilast, which has become a mainstay alongside topical corticosteroids. The product’s dual availability in cream and foam formulations gives providers and patients greater flexibility, allowing for more personalized care decisions through shared decision-making.

She concludes that the expanded approval of this agent in foam form has significantly advanced the topical PsO landscape. Its hydrating, cosmetically elegant formulation meets both clinical and lifestyle needs, helping patients manage scalp and body psoriasis more effectively and confidently.

In this video, the third in a 6-part series, panelists discuss recent advancements in PsO management.

 RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, to  dive into the clinical limitations of traditional topical therapies and explore how foam formulations offer meaningful advantages for high-impact areas like the scalp. 

In this clip, Shahriari emphasizes that even limited plaque burden on the scalp can cause disproportionate psychosocial distress due to visibility, itching, and flaking, which can significantly impair quality of life.

She highlights the difficulty of delivering standard topicals through hair to affected scalp skin and underscores the importance of formulation choice based on hair type and texture. For patients with Afro-textured or tightly coiled hair, daily shampoos or drying creams can be impractical or even harmful. Instead, foam, lotion, or oil-based vehicles are often better suited for these patients. Additionally, concerns about hair color treatments and cosmetic outcomes further influence adherence and satisfaction.

Shahriari notes that foam formulations in particular offer a cosmetically elegant, hydrating, and easy-to-apply alternative that is compatible with diverse hair types. With once-daily application and rapid itch relief, these vehicles may overcome common barriers to treatment and improve both comfort and outcomes for patients with scalp psoriasis.

In this video, the second in a 6-part series, panelists discuss recent advancements in PsO management.

In this video, the first in a 6-part series, panelists discuss recent advancements in PsO management.

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These data resulted from a sub-study of the open-label extension (OLE) of the randomized, placebo-controlled phase 3 ‘Balance’ analysis.

Latest News

Advocating for Patients With Psoriasis: Securing Access to Nonsteroidal Topicals Like Roflumilast

Bridging and Enhancing Biologic Response With Targeted Topicals for Scalp Psoriasis

Counseling Patients With Psoriasis on Roflumilast and Nonsteroidal Topicals

The Role of Roflumilast in Long-Term Psoriasis Management

Formulation Matters: Managing Scalp Psoriasis Across Hair Types