Podnosis Podcast: Bringing down costs in dermatology

Podnosis, the weekly podcast from Fierce Healthcare, explores the biggest issues shaping the healthcare industry. In a recent episode, host and Fierce Healthcare reporter Anastassia Gliadkovskaya spoke with Olivia Deitcher, CEO and founder of Zest Health, about one of the system’s most pressing challenges: rising healthcare costs.

One area drawing increasing attention is dermatology—and specifically the growing role of biologic medications in specialty drug spend.

Specialty medications like biologics are accelerating dermatology costs, with utilization climbing more than 30% year over year—a growth rate on par with some of the most expensive areas of medicine.

During the conversation, Olivia talks about how the issue isn’t simply the price of biologics. It’s how they are used—and how long patients remain on them.

Patients with chronic skin conditions like psoriasis and eczema are often escalated to high-cost biologics faster than necessary, sometimes even bypassing lower-cost treatments that could be effective when applied correctly. Limited patient education, time-constrained visits, and misaligned incentives can push care pathways toward the most expensive option rather than the most appropriate one which can be deprescription.

The episode explores what a different model could look like: remission-focused dermatology care that combines personalized treatment, patient education, and lifestyle support—with built-in opportunities to reassess biologic therapy once disease is controlled.

Olivia also highlights growing interest from payers and employers in care models that reduce unnecessary biologic use while improving outcomes. For many health plans, it reflects a broader shift toward value-based care in dermatology.