Challenges in accessing timely healthcare and potential cardiovascular risks associated with treatments for inflammatory bowel disease (IBD) have come to light in recent research presented at the Crohn’s & Colitis Congress. These findings highlight critical issues that impact patient care and health outcomes.
Inflammatory bowel disease encompasses conditions like Crohn’s disease and ulcerative colitis. Image credit: mi_viri – stock.adobe.com
Healthcare Access Challenges for IBD Patients
Individuals with IBD face significant hurdles in accessing necessary medical care. These barriers often force patients to skip or ration their medications, potentially leading to severe health complications.
A recent survey gathered anonymous feedback from 2881 patients and their caregivers. The majority of participants were female, predominantly had Crohn’s disease, and were insured. Among those insured, most had employer-provided coverage.
Survey respondents cited several reasons for difficulties in receiving IBD care, including unavailable appointments, lengthy insurance approvals, and limited medical office hours. Transportation issues and lack of in-network providers also posed challenges.
Prescription difficulties were widespread. Patients often experienced long delays due to insurance prior authorizations and excessive phone time with insurance companies. Additionally, some medications were not covered by insurance, either due to off-label prescriptions or step therapy restrictions.
To mitigate these issues, many patients took drastic measures to afford medications. These tactics included requesting lower-cost prescriptions, delaying fills, and skipping doses entirely. Some resorted to using alternative therapies or sourcing medications from other countries.
The study underscores the urgent need for healthcare system and policy reforms to enhance access to affordable care and medications for IBD patients.
Cardiovascular Risks of IBD Therapies
Research also compared the cardiovascular risks associated with two common biologic treatments for IBD: ustekinumab and vedolizumab. The study, based on electronic health records from a large patient cohort, revealed ustekinumab to have a lower risk of mortality and certain cardiovascular events compared to vedolizumab.
Using data from over 113 million US patients, researchers analyzed outcomes in approximately 5600 patients each treated with ustekinumab and vedolizumab. The study focused on patients aged 50 and older, who are at a higher risk for cardiovascular events and comorbidities.
The findings indicated that ustekinumab therapy was associated with a significantly lower risk of all-cause mortality, with 227 deaths compared to 317 for vedolizumab users. Similarly, patients on ustekinumab had a reduced risk of coronary revascularization and on-ST-segment elevation myocardial infarction.
However, the study did not find significant differences in the occurrence of other major adverse cardiovascular events, such as stroke and acute myocardial infarction, between the two treatment groups.
These results emphasize the importance of considering cardiovascular safety when selecting treatments for IBD, particularly in older patients.
Addressing both access to care and treatment safety is crucial in improving outcomes for patients with inflammatory bowel disease. Continuous advocacy and policy reforms can help ensure better care and reduce the burden of IBD on both patients and the healthcare system.
Join the conversation and share your thoughts on how we can improve healthcare access and treatment options for IBD patients. Your input is valuable in shaping the future of patient care.
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