Patients above the age of 65 have a higher prevalence of psoriasis. Their disease load has an adverse effect on their quality of life. While there is an obvious need to treat these individuals, there remain obstacles to overcome. This study aims to describe the problems that exist in the treatment of senior Medicare patients, as well as to give therapeutic recommendations for clinicians to follow if they face one or more of these challenges. When developing treatment plans for older psoriasis patients, providers encounter the following challenges: difficulties getting medication coverage through Medicare, increasing medical comorbidities, and polypharmacy. Providers strive for regimens that are inexpensive, safe, and effective, but it is not always obvious how to do this, particularly in senior Medicare patients. This study is important because it seeks to clarify the logistical challenges created by Medicare coverage and to give answers to regularly encountered difficulties in the treatment of a debilitating and common disease in a high-risk population. 

Alternative therapeutic alternatives to biologics and small-molecule inhibitors are specifically covered, and include topical treatments, phototherapy, methotrexate, acitretin, and cyclosporine, as well as corticosteroids and leflunomide for psoriatic arthritis. These treatments’ particular risks and advantages in the older population are discussed, allowing physicians to make patient-specific judgments concerning optimum regimens.