Phototherapy is a proven treatment method for the treatment of psoriasis, yet is typically underutilized because of the frequency of physician visits and copayments required for each session (typically 2-5 treatments/wk).  Injectable biologic therapies are effective but costly.  The objective of this study was to explore how changes in copayment strategies for phototherapy may affect biologic usage. Published estimates of the cost of phototherapy and biologic treatment were used to determine the costs of these treatments to patients and insurers.  With an estimated copayment of $30 per office visit and a pharmacy copayment of $50 per month, the $1800 annual patient expense for phototherapy far exceeds the out-of-pocket expenses for etanercept, alefacept, and efalizumab ($840, $405, and $780, respectively).  The estimated annual costs to MCOs ranged from $3,008 for phototherapy to $20,300 for Etanercept. Copayments for phototherapy may be shifting patients toward biologic treatment, which is more convenient but more costly to managed care plans.   Read full article