Moderate to Severe Psoriasis in Brazil: Challenges in Access to Biological Therapies within the Unified Health System
Moderate to Severe Psoriasis in Brazil: Challenges in Access to Biological Therapies within the Unified Health System
DOI:
https://doi.org/10.51473/rcmos.v1i1.2026.1941Keywords:
Psoriasis, Biological Therapy, Unified Health SystemAbstract
Psoriasis is a chronic, immune-mediated inflammatory disease that affects millions of people in Brazil and worldwide, with a significant impact on quality of life due to cutaneous lesions, physical symptoms, and associated comorbidities. Although conventional treatments such as methotrexate, cyclosporine, and phototherapy are effective for some patients, these approaches often present limitations related to sustained efficacy, safety profile, and long-term response. In this context, biological therapies—including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-12/23, IL-17, and IL-23 inhibitors—represent a major therapeutic advance in the management of psoriasis, providing improved clinical control, faster lesion clearance, and substantial improvement in patients’ quality of life. However, access to these medications in Brazil remains limited, particularly within the scope of the Unified Health System (Sistema Único de Saúde – SUS). Factors such as high costs, restricted incorporation of new biologics, regional inequalities in treatment availability, and the need for adequate infrastructure for drug administration contribute to unequal access, often relying on judicialization. This article reviews the main therapeutic advances in psoriasis treatment, outlines the current scenario of access to biological therapies in Brazil, and discusses the challenges that must still be addressed to ensure equitable and effective treatment for all patients.
Downloads
References
BRASIL. Ministério da Saúde. Pacientes adultos com psoríase passam a contar com novo medicamento no SUS. Diário Oficial da União, 21 set. 2020. Disponível em: https://www.gov.br/saude/pt-br/assuntos/noticias/2020/setembro/pacientes-adultos-com-psoriase-passam-a-contar-com-novo-medicamento-sus.
COSTA, T. et al. Uso de ustekinumabe no tratamento da psoríase grave: uma revisão. Anais Brasileiros de Dermatologia, v. 95, n. 2, p. 112-118, 2025.
DUARTE, G. V. et al. Epidemiology and treatment of psoriasis: a Brazilian perspective. Patient Preference and Adherence, v. 9, p. 1-7, 2015. DOI: https://doi.org/10.2147/PTT.S51725
ELSISI, A. E. Comprehensive review of oral medications in psoriasis. European Journal of Pharmacology, v. 894, p. 1-10, 2025. DOI: https://doi.org/10.1016/j.ejphar.2021.173889. DOI: https://doi.org/10.1016/j.ejphar.2021.173889
FERRARA, F. et al. Therapeutic advances in psoriasis: From biologics to small molecules. Frontiers in Pharmacology, v. 15, p. 1-14, 2024. DOI: https://doi.org/10.3389/fphar.2024.00001.
JANSEN, M. et al. Impacto psicossocial da psoríase: além da pele. Revista Brasileira de Dermatologia, v. 100, n. 2, p. 123-130, 2023.
JOHNSON, R.; SMITH, A. Epidemiology of psoriasis in South America: A review. Journal of Dermatology Research, v. 12, n. 1, p. 45-53, 2023.
LEE HJ, Kim M. Challenges and future trends in the treatment of psoriasis. Int J Mol Sci. 2023;24:13313. DOI: https://doi.org/10.3390/ijms241713313
LOPES, N. et al. Access to psoriasis drug treatment among Brazilian patients: A study of the judicial system. Value in Health, v. 20, n. 3, p. 1-7, 2017. DOI: https://doi.org/10.1016/j.jval.2017.01.006. DOI: https://doi.org/10.1016/j.jval.2017.08.963
LOPES, L. C. et al. Biological drugs for the treatment of psoriasis in a public health system: Access and utilization profile. Journal of the European Academy of Dermatology and Venereology, v. 28, n. 5, p. 1-7, 2014. DOI: https://doi.org/10.1111/jdv.12198. DOI: https://doi.org/10.1111/jdv.12198
OLIVEIRA, R. T. G. et al. Socioeconomic impact of high-cost drugs in Brazilian public health. Anais Brasileiros de Dermatologia, v. 96, n. 1, p. 1-7, 2021. DOI: https://doi.org/10.1016/j.abd.2021.01.003. DOI: https://doi.org/10.1016/j.abd.2020.08.010
OŻÓG, M. K. et al. New therapies in the biological treatment of psoriasis. Journal of Clinical Medicine, v. 5, n. 2, p. 1-10, 2025. DOI: https://doi.org/10.3390/jcm5020019. DOI: https://doi.org/10.3390/allergies5020019
ROMITI, R. et al. Brazilian Consensus on Psoriasis 2020 and Treatment Algorithm of the Brazilian Society of Dermatology. Anais Brasileiros de Dermatologia, v. 96, n. 6, p. 778-781, 2021. DOI: https://doi.org/10.1016/j.abd.2021.02.003. DOI: https://doi.org/10.1016/j.abd.2021.03.007
SALLAM, M. A. E. et al. Efficacy and safety of biologic therapies for treatment of psoriasis: A systematic review. QJM: An International Journal of Medicine, v. 117, n. Supplement_2, p. hcae175.214, 2024. DOI: https://doi.org/10.1093/qjmed/hcae175.214. DOI: https://doi.org/10.1093/qjmed/hcae175.214
SBD – SOCIEDADE BRASILEIRA DE DERMATOLOGIA. Consenso Brasileiro de Psoríase. São Paulo: SBD, 2020.
SCHOENARDIE, P. et al. Real-world effectiveness of biological therapies in psoriasis: A multicenter study. Dermatology Therapy, v. 34, n. 4, p. 1-12, 2024.
SILVA, F. et al. Tratamentos convencionais da psoríase: eficácia e limitações. Anais Brasileiros de Dermatologia, v. 97, n. 4, p. 389-395, 2022. DOI: https://doi.org/10.1016/j.abd.2020.08.037
SOUZA, João Venícios Tavares; MELO, Mariana Santos; SANTOS, Bárbara Cavalcante; FENELON, Antonio Tiago da Costa. Prevalência e fatores de risco para psoríase no Brasil: uma revisão epidemiológica. Contribuciones a las Ciencias Sociales, São José dos Pinhais, v. 17, n. 13, p. 1-24, dez. 2024. DOI: 10.55905/revconv.17n.13-278. DOI: https://doi.org/10.55905/revconv.17n.13-278
VIEIRA, M.; ZUCCHI, P. Judicialization of access to high-cost drugs in Brazil: challenges and implications. Health Policy, v. 116, n. 2, p. 123-130, 2014.
VAN MUIJEN, M. E. et al. Direct comparison of real-world effectiveness of biologics in moderate-to-severe plaque psoriasis. Journal of the American Academy of Dermatology, v. 87, n. 5, p. 1010-1016, 2022. DOI: https://doi.org/10.1016/j.jaad.2022.05.041. DOI: https://doi.org/10.1016/j.jaad.2022.05.041
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Ana Flávia Pomin Frutos da Silva , Juliene Amanda Salvador , Lariane Garcia de Carvalho , Karine Franco, Leticia Rose Kurunzi (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This means you are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The use of this material is conditioned upon proper attribution to the original author(s), providing a link to the license, and indicating if changes were made. The license does not require permission from the author or the publisher as long as these conditions are met.
The Creative Commons license logo is displayed permanently in the footer of the journal.
The copyright of the manuscript can be retained by the authors without restrictions and can be requested at any time, even after publication in the journal.
How to Cite
