Administrative Burden of iPLEDGE Deters Isotretinoin Prescriptions: Results From a Survey of Dermatologists.

The requirements of the iPLEDGE program place burdens on both patients with severe recalcitrant nodular acne and prescribers of isotretinoin. We sought to investigate the changes in dermatologists' acne treatment patterns due to the administrative burden of iPLEDGE by assessing whether dermatologists chose not to prescribe isotretinoin to appropriate patients because of the labor of iPLEDGE requirements. Additionally, we investigated the medications that were substituted for isotretinoin. An anonymous online survey was created and posted on a dermatology group on social media. The survey respondents (N=510) consisted of board-certified dermatologists across the United States and comprised a wide variety of ages and practice types. This survey ultimately highlighted the burden of iPLEDGE for American clinicians and the need for a more streamlined risk-management program. This program is deterring some US clinicians, especially those younger than 46 years, from prescribing isotretinoin and limiting patient access to an effective medication.