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Should insurance companies cover acne medications at any age?

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For anyone suffering with acne, it’s a constant struggle to find soaps or face washes that might alleviate the problem.  According to Acne Resource Center about 80 percent of teenagers suffer with acne, some of which is so severe it leads to scars.  However, it’s not just an issue people outgrow.  About 20 million adults also have acne and many insurance companies will only cover treatment for teens and young adults.

The insurance facts
In a report published in the Journal of the American Academy of Dermatology, Drs. Steven Feldman and Alan Fleischer recommend raising the age for insurance coverage of the drug to at least 40.

“We found that many insurance companies refuse to pay for tretinoin, a common acne treatment, for patients older than 25,” said Feldman, associate professor of dermatology and pathology.

Tretinoin, sold under the brand names Retin-A and Renova, is effective in treating not just acne but also sun-damaged skin. Fleischer, associate professor of dermatology, said that because many insurance companies do not pay for cosmetic services, they cut off coverage of Renova in the belief that acne is mostly an affliction of teens and young adults.

The hope
The two doctors studied this issue to give insurance companies the facts when it comes to acne, hoping they will consider raising the age limits or lifting them all together.

“We found that even among people age 33, 75 percent of tretinoin prescriptions were for acne,” Feldman said. “And at age 40, 63 percent of the prescriptions still were for acne. Prescriptions for acne did not balance with those for photoaging and other skin conditions until the age of 46.6.”

Given this data, Fleischer said, “We concluded that the cut-off, if used, should be at least 40 years.”

 

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