Jason Hawkes, MD, highlights issues related to prior authorization as well as raising awareness of chronic urticaria, HS, atopic dermatitis, and other diseases.
Hawkes, who spoke in
Hawkes explained that clinicians have long recognized recurring clinical patterns among patients with type 2 inflammatory disease, even before today's expanding medication landscape. Histories of childhood allergy, asthma, allergic rhinitis, and eczema often point toward shared inflammatory pathways. He described newer targeted therapies as allowing clinicians to better connect these characteristics with specific approaches to therapy.
Despite this progress, he noted that the healthcare system has not fully embraced individualized treatment. Step therapy requirements and prior authorization policies often require clinicians to prescribe medications based on formulary restrictions rather than selecting therapies they believe best fit a patient's clinical profile.
Hawkes suggested that while cost containment remains important, these policies can limit physicians' ability to practice personalized medicine and delay effective treatment for patients with chronic inflammatory skin diseases. He added that future research should focus on developing biomarkers or other objective measures that help clinicians identify the therapies most likely to succeed before treatment begins.
Hawkes also highlighted conditions he believes remain underrecognized despite increasing awareness. He pointed to chronic urticaria, mild asthma, hidradenitis suppurativa (HS), and atopic dermatitis itself, noting many patients continue to go undiagnosed or remain managed exclusively in primary care settings before reaching specialists. Earlier recognition of these interconnected type 2 inflammatory diseases could improve access to appropriate therapies as well as comprehensive care.
Looking ahead, Hawkes identified disease remission as one of the field's most important unanswered questions. He noted that some individuals naturally outgrow atopic dermatitis while others experience persistent disease into adulthood, yet the mechanisms underlying this difference remain poorly understood. Determining how the immune system achieves spontaneous remission could ultimately inform strategies aimed not only at controlling symptoms but also at inducing long-term remission or even preventing chronic disease altogether.
Disclosures: Hawkes has served as a consultant, advisory board member, investigator, and speaker for multiple pharmaceutical companies involved in dermatology, including AbbVie, Arcutis, Blueprint Medicines, Eli Lilly, Galderma, Incyte, Janssen, LEO Pharma, Novartis, Regeneron, Sanofi, Sun Pharma, Takeda, and UCB, among others. He has also received research funding and reports stock ownership in Regeneron.
References
