Drug Utilization Review Commission

c/o Oklahoma Health Care Authority

4345 N Lincoln Blvd

Oklahoma City, OK 73105

Cc: Devin Wilcox, Pharmacy Director, Oklahoma College of Pharmacy; Melissa Miller, Oklahoma Medicaid Director

Subject: Please Support Improvements to Oklahoma Medicaid’s Step Therapy Policy for Hidradenitis Suppurativa

Dear Members of the Oklahoma Medicaid Drug Utilization Review Commission,

My name is [Your Full Name], and I am a resident of [City], Oklahoma. I live with hidradenitis suppurativa (HS), a painful, chronic, and often disabling inflammatory skin disease. I am writing to respectfully urge the Commission to review and update Oklahoma Medicaid’s step therapy and utilization management criteria for biologic treatment of HS.

Living with HS has been one of the most painful and isolating experiences of my life. The disease causes deep, recurring abscesses and inflamed nodules that can make it difficult to move, work, or even sleep. [Share a brief personal experience, how HS affects your daily life, work, relationships, or mental health.]

Under Oklahoma Medicaid’s current policy, patients must have moderate-to-severe disease, document at least three abscesses or inflammatory nodules, and fail multiple prior treatments before becoming eligible for biologic therapy, even when our doctors believe a biologic is the most appropriate treatment.^[1] These requirements can delay effective care and allow the disease to worsen.^[2]

Antibiotics and other treatments may provide temporary relief, but they often do not stop HS from progressing. Over time, HS can cause irreversible damage, including scarring and tunnel-like wounds beneath the skin that make treatment more difficult and less effective. By the time many patients finally gain access to biologic therapy, years of suffering may have already passed.

The longer patients must wait for effective treatment, the more we lose, not only in health, but also in our ability to work, participate in our communities, and live without constant pain. HS already carries a heavy burden of physical pain, emotional distress, and stigma. Policies that delay effective treatment only make that burden harder to bear.

I respectfully ask the Commission to consider the following updates to Oklahoma Medicaid’s policy:

• Maintain the requirement of a confirmed diagnosis of moderate-to-severe HS (such as Hurley Stage II or III);
• Allow access to biologic therapy after failure of a single prior systemic therapy; and
• Remove the requirement for documentation of three or more abscesses or nodules, which is not supported by current clinical guidelines.

These changes would help ensure that people living with HS can receive timely, evidence-based care before the disease causes irreversible damage. For patients like me, earlier access to appropriate treatment could mean less pain, fewer complications, and a better chance at living a healthy and productive life.

Thank you for your time, your service, and your commitment to improving care for Oklahomans covered by Medicaid. I appreciate the opportunity to share my experience and respectfully ask the Commission to consider these changes that could make a meaningful difference for patients living with HS.

Sincerely,

[Your Full Name]

[City], Oklahoma

[Email / Phone – optional]