Inflammatory bowel disease (IBD) patients who required treatment with biologics and were enrolled in a financial assistance program were less likely to need surgery after starting medication than those who were not enrolled in a program, according to a study by UT Southwestern researchers.
There are gaps in the care of patients with IBD. Our project identified that providing biologic therapy to IBD patients with a financial assistance program would have better outcomes compared to patients with a delay in receiving treatment.”
Moheb Boktor, MD, Associate Professor of Internal Medicine in the Division of Gastroenterology and Hepatology at UTSW and lead author
Low socioeconomic status is a well-known risk factor for poor health outcomes and higher utilization of health care resources in a wide range of chronic conditions. Financial assistance programs are designed to improve health care for patients of low socioeconomic status by reducing the cost of medical care.
For patients with IBD, such as Crohn’s disease or ulcerative colitis, a delay in treatment can significantly worsen their condition, leading to increased long-term morbidity and healthcare costs. Therefore, access to quality, affordable health care can have a significant impact on overall outcomes.
The study, which was published in Pathophysiology, used medical records of indigent IBD patients treated at Parkland Health to evaluate the impact of financial assistance programs on health care and resource utilization. The hospital’s “safety net” program gives poor patients access to deeply discounted drugs without requiring authorization from health insurance companies.
Adult patients who started a new biologic drug for the treatment of IBD between January 2010 and January 2019 were included in the study. The researchers classified the patients according to whether they were enrolled in the financial assistance program or covered by private or state insurance.
Compared to insured patients, patients enrolled in the program were less likely to require surgery. This was consistent even when controlling for variables such as age, gender, race, and disease complexity/severity.
Interestingly, patients who received financial assistance also underwent more imaging studies before requiring surgery than patients who were not on the program. The researchers believe this may be due in part to easier access to needed scans due to insurance claims and unclaimed co-payments. Access to imaging could explain the need for fewer surgeries, as these studies could be used to adjust treatment plans. However, more research is needed to fully explore these possibilities and whether financial aid enrollment reduces disease severity.
Providing non-invasive treatment for IBD minimizes complications and achieves a normal quality of life for patients, says Dr. Boctor said. Partnerships between health systems and pharmaceutical companies can potentially close such gaps in healthcare management for patients with IBD and other chronic diseases.
Other UT Southwestern researchers who contributed to this research include Phillip Gu, Andrew Gilman, Christopher Chang, David I. Fudman and Ezra Burstein. Elizabeth Moss of Ambulatory Care Pharmacy at Parkland Health also contributed.
UT Southwestern Medical Center
Gu, P., and more. (2022) Improved access to health care reduces surgical requirements in poor IBD patients using biologic therapy: a “safety net” hospital experience. Pathophysiology. doi.org/10.3390/pathophysiology29030030.