Q&A: Patients with Eczema Continue to Face Insurance Barriers

Why It Matters

Insurance barriers delay effective care for millions, increasing disease complications and healthcare costs. Reforming step‑therapy through the Safe Step Act could unlock timely treatment, improving outcomes and reducing overall burden.

Key Takeaways

• 40% face insurance coverage issues annually
• 15% never start prescribed eczema medication
• Safe Step Act seeks to end step‑therapy barriers
• Survey: 68% adults report uncontrolled eczema symptoms
• Bipartisan support growing for eczema treatment reform

Pulse Analysis

Eczema affects roughly one in ten Americans, making it one of the most common chronic inflammatory skin conditions. Over the past decade, biologics and targeted therapies have dramatically improved disease control, yet patients often hit a wall when insurers impose step‑therapy protocols or require cumbersome prior authorizations. These administrative hurdles not only postpone effective treatment but also raise the risk of secondary infections, mental‑health strain, and higher overall medical spending.

The National Eczema Association’s 2025 survey of 1,500 adults and caregivers paints a stark picture: 40% reported at least one insurance‑related obstacle in the past year, 12% were forced to discontinue a prescription, and 15% never started a doctor‑recommended medication. Nearly a quarter of respondents attempted to retry a medication only to encounter a 56% prior‑authorization failure rate. Step‑therapy, which mandates cheaper alternatives before approving the prescribed drug, emerged as the most frequent barrier, underscoring a misalignment between clinical best practices and payer policies.

In response, NEA advocates have intensified lobbying for the Safe Step Act, legislation that would obligate group health plans to provide a rapid exceptions process when step‑therapy is clinically inappropriate. Bipartisan interest is growing, but the bill remains stalled, highlighting the need for continued stakeholder engagement. Dermatologists, patient groups, and industry leaders can amplify pressure by submitting comments, joining Capitol Hill visits, and educating legislators about the real‑world impact of coverage delays. Aligning insurance policies with modern therapeutic options promises to reduce disease burden, lower long‑term costs, and deliver better quality of life for millions of eczema patients.