Moving Corticosteroid Stewardship into Policy, With Killian Lozach, MBA

At the National Corticosteroid Stewardship Summit in Washington, DC, Killian Lozach, MBA, business development and alliance management lead at Woodberry Associates, described how the Corticosteroid Stewardship Alliance (CSA) aims to move corticosteroid stewardship into policy and coverage discussions by pairing clinician data with the downstream costs of adverse events. Lozach moderated the summit's policy session, "Advancing Policy, Coverage, and Stewardship Solutions."

Even short courses of systemic corticosteroids have been linked to fracture, blood clots, gastrointestinal bleeding, mood changes, heart failure, and sepsis, according to the Urgent Care Association.¹ CSA, a collaborative initiative of the Derma Care Access Network and Arcutis Biotherapeutics, aims to protect patients from avoidable steroid-related harm by advancing clinical standards, improving monitoring practices, and reforming policy structures, which incentivize overuse.²

"All these adverse events are accumulating into health care costs, which the system is paying for: Medicare, Medicaid, and our commercial system," Lozach told HCPLive.

How CSA Frames Corticosteroid Stewardship for Policymakers

As a new alliance, CSA is starting by listening to clinicians on its medical advisory board and examining their prescribing data, Lozach said. The goal is to use those data to open conversations with policymakers about steroid-related adverse events and their cost to Medicare, Medicaid, and commercial insurers.

Translating the evidence into terms lawmakers can act on is often the final step, according to Lozach. He described the alliance's early conversations with policymakers as bipartisan, with several lawmakers noting personal experience with steroid treatment and asking whether they should be paying attention.

Lozach acknowledged Capitol Hill is fielding many competing requests, and corticosteroid stewardship is not necessarily at the top of the agenda. Events such as the summit help clinicians, patients, and advocates speak with one voice and make the issue worth a 15-minute conversation with a policymaker, he said.

Stewardship Guidelines and Payer Coverage Gaps

No formal corticosteroid stewardship guidelines exist yet, Lozach noted, and much of CSA's work with clinicians focuses on defining what those guidelines should include, since the field so far has only a shared sense of the direction it would like them to move. Payers, in his view, operate under legitimate cost-containment pressures in a system he described as expensive and business-driven.

The alliance's argument to payers centers on back-end spending. By showing insurers data on the costs of steroid-related adverse events, CSA hopes to paint a picture payers can act on and build a case for coverage reform.

Clinicians also report payers pointing to existing guidelines as the reason to decline coverage for certain options, Lozach said. For this reason, he stressed medical societies must lead in publishing stewardship guidelines, giving both patients and clinicians a foundation to advocate for payer reform.

How Clinicians Can Support Corticosteroid Stewardship at a Systems Level

Lozach described several entry points for clinicians. Some may choose to meet with lawmakers on Capitol Hill. Stewardship also happens in the exam room. Lozach pointed to taking an extra 5 or 10 seconds to review the label with a patient, explain the reason for short-term, acute use, and disclose possible adverse events, a practice he noted many clinicians already follow. Physicians, nurses, physician assistants, and nurse practitioners can also raise stewardship with medical society leadership.

"This is going to take years, but we're here to do it, and we've got amazing partners who are willing to take this journey with us,” Lozach said.

References

1. Corticosteroid stewardship. Urgent Care Association. Accessed September 24, 2026. https://urgentcareassociation.org/learning-center/trending-topics/corticosteroid-stewardship/

2. About the Corticosteroid Stewardship Alliance. Corticosteroid Stewardship Alliance. Accessed September 24, 2026. https://csstewardship.org/about/