A research letter, published by members of the George Washington University School of Medicine and Health Sciences (SMHS) and Children’s National Hospital (Children’s National) in the Journal of the American Academy of Dermatology (JAAD), details results of a study that found a gap in access to treatment for severe acne among low-income communities.
The prescription of isotretinoin, a treatment for severe acne, is regulated by the United States Food and Drug Administration’s iPLEDGE program, according to the authors, third-year SMHS MD student Nidhi Shah and Anna Kirkorian, MD, interim chief of Dermatology at Children’s National and assistant professor of dermatology at SMHS. However, pharmacies must participate in the iPLEDGE program to prescribe isotretinoin.
The study analyzed the distribution of iPLEDGE pharmacies in the District of Columbia.
Shah and Kirkorian found that 82% of outpatient pharmacies in D.C. were enrolled in iPLEDGE; all chain pharmacies were enrolled, along with 46% of independent pharmacies and 60% of hospital pharmacies. However, they also found a “strong positive correlation between iPLEDGE pharmacy density and median household income.” In addition, they note that iPLEDGE pharmacy density has a strong negative correlation with the percentage of individuals with insurance.
“Residents of low-income communities have to travel further to access an iPLEDGE pharmacy, thereby incurring additional costs and hindering timely access to isotretinoin,” they wrote.
In addition, while the data only reflect findings for D.C., they predict that “cities with similar income inequality as D.C. also have similar iPLEDGE pharmacy distribution.”
Future studies, according to the authors, should examine the relationship between pharmacy distribution, isotretinoin needs in the community, and medication adherence.
The letter, titled “Relationship between sociodemographic factors and geographic distribution of pharmacies dispensing isotretinoin,” is published in JAAD.
