The Podcast by KevinMD Sustainable legislative reform outweighs temporary discount programs
Jan 9, 2026
Leah M. Howard, President and CEO of the National Psoriasis Foundation, dives into pressing health care reforms. She critiques the recent rise of direct-purchase drug programs, arguing that they can't substitute for systemic legislative change. Howard champions the Safe Step Act, emphasizing its potential to protect patients from expensive step therapy practices. The discussion highlights the need for transparent pharmacy benefit manager reforms and systemic solutions that prioritize patient health over corporate profits.
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Grassroots Origin Of NPF
- Leah Howard describes the National Psoriasis Foundation's origin from a single newspaper ad that connected isolated patients.
- That grassroots response grew into the largest nonprofit serving about 8 million people with psoriatic disease.
Systemic Reform Trumps Siloed Fixes
- The NPF pushes legislative guardrails for step therapy to let clinicians and patients bypass inappropriate forced treatments.
- Leah argues direct-to-consumer drug offerings can't replace deep systemic reforms like PBM transparency.
Document To Navigate Step Therapy
- Clinicians should document reasons a specific therapy is best to navigate step therapy protocols and exceptions.
- Use prior treatment history and contraindications to support timely exceptions for patients.