New approaches to moderate to severe psoriasis unburden even the most stubborn cases.  This progression stems from recent understanding of the disease as an immune abnormality leading to chronic skin inflammation.  Over the past decade “biologics” have supplanted topical steroids and tar ointments when the disease covers more than 10% of the skin’s surface.
 
Early biologics including Humira, Enbrel and Remicade offer moderate relief but targeted a wider swath of the immune system.  Newer drugs narrow their focus and offer a greater likelihood of complete skin clearance within a relatively short timeframe.  Among the new generation are Cosentyx, Taltz and now Tremfya.
 
Tremfya is the first drug to specifically attack a critical messenger in the inflammatory cascade.  It blocks the ability of IL23 to initiate the process leading to the psoriatic  manifestations of redness, itching and skin discomfort.
 
Treatment may be administered by either the patient or health care practitioner.  After an initial subcutaneous injection and another 1 month later, therapy continues with a single shot every 8 weeks.
 
First the good news – after 16 weeks, about 85% of patients initially suffering moderate to severe disease can expect clear or almost completely clear skin.  The bad news – the cash price for the drug is well is excess of $10,000.00 a syringe or $60,000.00 each year.  For those paying full price this averages $225 every day.
 

Fortunately the drug company whose sales exceed $200,000,000.00 each day are kind enough to offer a copay card that limits your out of pocket cost to $5 per syringe.  They seem content to reap their rewards from the insurance companies who in turn raise their premiums on everyone to cover these inflated charges.