In this HCPLive 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.
Our Panelists:
Mona Shahriari, MD, 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 HCPLive's podcast, The Medical Sisterhood.
David Hartigan, 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.
REFERENCE
