In the past decade, tumor necrosis factor-alpha (TNF-α) inhibitors, including AbbVie’s Humira and Amgen’s Enbrel, and Janssen’s interleukin IL-12/23 inhibitor Stelara have been leading the U.S. psoriasis biologics market. However, the recent wave of U.S. approvals of novel psoriasis agents is altering the market landscape. Celgene’s oral agent Otezla has been successfully carving out a space in biologics-naive patients. More-effective biologics—the IL-17 inhibitors Novartis’s Cosentyx and Eli Lilly’s Taltz—are threatening the first-line dominance of the TNF-α inhibitors, and Janssen’s IL-23 inhibitor Tremfya is likely to follow. With the recent entry of biosimilars and another IL-23 inhibitor, an IL-17 A/F dual inhibitor, and an oral TYK2 inhibitor in late-phase development, marketers of psoriasis therapies must learn how to overcome the formulary and uptake challenges facing current and emerging therapies in this increasingly competitive market.