Recent findings presented at the Crohn's & Colitis Congress reveal significant challenges in inflammatory bowel disease (IBD) treatment access and important differences in cardiovascular safety profiles between common biologics used in IBD management.
Healthcare Access Barriers Impact IBD Patient Care
A comprehensive national survey of 2,881 participants, including both patients (86.1%) and caregivers (13.9%), has uncovered substantial barriers to IBD care access. Despite high insurance coverage rates (98% of respondents), patients face multiple obstacles in receiving appropriate medical care.
The study identified appointment availability as the primary barrier, affecting 39% of respondents. Other significant challenges include extended insurance approval waiting periods (26%), difficulty reaching medical offices (19%), and work-related time constraints (19%). These access issues have led to concerning patient behaviors, with many resorting to potentially dangerous cost-saving measures.
"IBD patients continue to experience significant access to care challenges, often having to make dangerous tradeoffs, such as skipping or rationing their medications," the researchers noted. Nearly a quarter of patients (23.6%) requested lower-cost prescriptions, while 22.9% delayed filling their prescriptions, and 20.6% abandoned them entirely.
Cardiovascular Safety Comparison Between IBD Biologics
A separate population-based cohort study examined cardiovascular outcomes in older adults treated with two common IBD biologics: ustekinumab (Stalera) and vedolizumab (Entyvio). The study, which analyzed data from 11,216 matched patients aged 50 and older, revealed significant differences in cardiovascular risk profiles.
Key findings demonstrate that ustekinumab treatment was associated with:
- Lower all-cause mortality (RR, 0.716; 95% CI, 0.606-0.846)
- Reduced risk of coronary revascularization procedures
- Decreased incidence of non-ST-segment elevation myocardial infarction (RR, 0.667; 95% CI, 0.473-0.939)
The study population, with a mean age of 61.9 years and predominantly female (53.8%), was followed for a median of 3.1 years. While differences were observed in several cardiovascular outcomes, researchers found no significant variations in major adverse cardiovascular events, stroke, or acute myocardial infarction between the treatment groups.
Insurance-Related Medication Challenges
The research highlighted significant insurance-related obstacles affecting medication access. Notable findings include:
- 39.1% of patients experienced delays exceeding two days due to prior authorization requirements
- 28.1% spent more than two hours on insurance-related phone calls
- 29.8% faced prescription coverage denials
- 26.1% encountered issues with off-label prescriptions
- 24.8% were affected by step therapy restrictions
These findings underscore the urgent need for healthcare system reform and policy changes to improve care accessibility and medication affordability for IBD patients. The research also provides valuable insights for healthcare providers in selecting appropriate biological therapies, particularly for older adults with IBD who may have elevated cardiovascular risk factors.
