Globally, psoriasis affects 125 million people (7.5 million adults in the U.S.) at an annual cost of $112 billion. Of that $112 billion, $36.4 billion is spent on comorbidities associated with the immune-mediated disease.
As the head of business development for the pharmaceutical vertical at Twill, I see this as a huge opportunity to improve people’s lives and reduce healthcare costs through early detection, diagnosis and support.
The Impact of Digital Therapeutics and Digital Care Delivery on People with Psoriasis
In 2021, Twill Care for Psoriasis became the official online community for the National Psoriasis Foundation. Today, more than 65,000 people with psoriasis are able to access Twill’s Twill Care digital healthcare community.
All of our Twill Care communities, including psoriasis, bring healthcare professionals together with high-quality digital tools within our Twill wellness product. The combination of community and digital therapies aim to help people with psoriasis learn about their illness, share their experiences, engage in exercises that reduce anxiety and depression, and gain support from each other in an equitable, stigma-free environment.
Twill Care, which is supported by licensed health and wellness providers, gives users access to scientifically validated content in Twill (Therapeutic Media), and uses customized applications and digital therapies to help people manage their psoriasis and psoriatic arthritis (like our psoriatic arthritis early detection tool). The customer experience is powered by the Therapeutic Intelligence™ AI that is built into our platform to personalize the experience for each individual user.
In Twill Care, we’re able to collect data and insights from our users through voluntary customer surveys and on Twill our research team is able to analyze our clinical assessment tools to measure outcomes.
Here’s what we’ve learned from our surveys:
- Psoriasis comes with a large emotional burden: Twill Care user surveys showed that one of the most challenging aspects of psoriasis is dealing with the emotional and mental impact of flare ups. Users say the biggest challenge they find when seeking emotional support is that they feel as if people who don’t have psoriasis don’t “get it."
- Choosing the right treatment is hard: Twill Care user surveys also found that the biggest challenge people faced was typically finding the right treatment option (41.1%)
- Diet impacts psoriasis: Twill Care surveys found that 91% of users believe their diet impacts their psoriasis. Of those, only 12% said their doctor recommended dietary changes and 95% have not seen a nutritionist. The top foods that members think help their psoriasis are fruits and vegetables, as well as gluten-free or dairy-free diets.
- Twill Care encouraged patients to seek physician intervention: Twill Care user surveys show a 37% increase in the number of people who sought professional treatment for their psoriasis within two months of joining the community.
- Twill Care impacts a patient’s decision to switch medications: Twill Care surveys showed that 14% of users switched their medication after joining Twill Care. Of those who did, 10% said an article or video on Twill Care was the reason they switched and 10% credited their decision to switch drugs to a post from a Twill Care expert.
- Used as Directed: A pilot study with 219 Twill users with self-reported psoriasis found that those who completed 16 or more activities within the platform (recommended usage) reduced their anxiety by 26% and increased their subjective well-being by 27%.
- Under Utilized: Even among users who completed 15 or fewer activities (less than recommended usage) improved their anxiety scores by 8% and improved subjective well-being scores by 4%.
Why Now? The Mental Health Epidemic & Psoriasis
The war in Ukraine overshadowed what should have been a wake-up call in President Biden’s State of the Union address this past March.
The President pledged over $6 billion of the 2023 federal budget to expand and improve mental health support services domestically - a clear acknowledgement of the fact that the mental health of the country is fragile in a post-COVID world.
We all connect, in some way, with the global mental health pandemic. Whether it's through our own experiences or the experiences of our children, family or friends, so much has changed so fast, and we’re all struggling to catch up.
I connect to it in my work when I think about the psychosomatic impact that mental health has on people with psoriasis. There’s ample research to show that anxiety and depression can impact the frequency and severity of psoriasis symptoms.
The president’s pledge to invest in mental healthcare, including $455 million for researching new care models and expanding early intervention services, will have a direct impact on mental health. But, even more importantly, this is an investment in the reduction of chronic illnesses, like psoriasis, by treating the mind and body as a connected unit.
In January 2022, Twill’s Health Economics Outcomes Research (HEOR) team published research showing that the prevalence of depression nearly doubles when you account for people with “unrecognized depression.” These are people whose clinical assessments show symptoms of depression, but who fail to acknowledge that they’re depressed when the assessment occurs.
The HEOR analysis also found that, after controlling for factors like age, gender, depression severity and comorbidities, people with unrecognized depression had direct healthcare costs that were 149% higher than costs for people who were aware of their depression.
When you combine the insights from our qualitative user surveys, the clinical analysis from our research teams, our HEOR analysis and the engagement we see from our users, it’s inspiring to think about the potential our digital therapeutics could have to make a meaningful impact on people’s lives and to significantly reduce healthcare costs.