Oldies but Goodies - The Utility of Older Generic Medicines in the Current Practice of Dermatology

In a presentation led by Matt Keller, Interim Chair of Dermatology at Thomas Jefferson University, the discussion focused on the utility of older generic medications in dermatology, specifically cyclosporin, methotrexate, and mycophenolate. The speakers emphasized the cost-effectiveness of these older treatments compared to newer, more expensive biologics, which often require prior authorization and can be inaccessible for underinsured patients. They highlighted the importance of understanding the safety profiles of these drugs, noting that, despite concerns about long-term side effects, maintaining a solid knowledge of these medications allows healthcare providers to manage conditions like psoriasis effectively, even in elderly patients or those with unique health challenges. Cyclosporin, often falling out of favor among younger providers, remains effective for severe plaque psoriasis with appropriate monitoring of kidney function and blood pressure. Methotrexate is acknowledged as safe for older patients when prescribed cautiously, and mycophenolate is a versatile, reversible option for patients needing steroid-sparing therapy without significantly increasing the risk of cancer. The presentation advocates for the thoughtful application of these older drugs, considering both their efficacy and safety, especially for populations that may not have access to newer therapies. Overall, the message promotes the idea of equitable care by utilizing familiar, effective treatments in dermatology.