Methotrexate use in psoriasis not uniform

[Caroline]

For me an experienced dermatologist who prescribes methotrexate is NOT an experienced dermatologist.
It makes no sense poisoning people.

It's all about the Benjamins. Let's start with the cheapest drug and who gives a care if it works. That's four years of saving until the patient liver start's to give out. That is the way it is here unless you have non government subsidized insurance.

You are totally right. That is also what they told me over here, it is the protocol to start with the cheapest, and in reverse this may turn out to be the most expensive route when you really turn sick.
That is not only with drugs, it is common for the current management approach in large projects like high speed trains or fighting airplanes.