Study: Over 40% of Irritable Bowel Disease Patients Struggle to Afford Proper Healthcare

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A recent survey by the Crohn's & Colitis Foundation found that many inflammatory bowel disease (IBD) patients face significant barriers to accessing healthcare, including financial challenges and insurance-related medication access issues, leading to adverse health effects and highlighting the need for reforms to reduce these disparities.

The survey aimed to provide updated information on a 2017 survey that highlighted the access barriers that significantly affect patients with IBD. The authors of the current study implemented a 52-question online survey evaluating access to healthcare professionals, medications, and procedures; associated financial challenges; and patient awareness of education and advocacy tools to navigate IBD care barriers. The survey was disseminated through multiple channels to IBD patients and their caregivers. A total of 2,200 patients completed the survey.

A majority of the patients involved in the study had Crohn disease that was diagnosed prior to 2021, with disease activity relatively split between mild, moderate, and severe. Most participants received healthcare via a clinic, professional office, a Department of Veterans Affairs (VA) medical center or VA outpatient clinic, a healthcare facility that was an academic setting, or through telehealth. Other IBDs included ulcerative colitis, which comprised 30% of the study’s participants.

Results found that among patients prescribed medication for IBD, 63% encountered financial barriers that led to missed doses of medication, with 66% of these patients experiencing adverse health effects as a result. Fifty-six percent faced medication access issues due to problems with insurance. Further, close to 25% faced step therapy or fail-first mandates, which forced them to try and fail on other medications before getting their prescribed treatment. The study also found that patients’ access to healthcare differed based on their age, type of medication prescribed, and type of health insurance.^1,2

"These findings underscore the urgent need to address healthcare disparities in IBD care," said Michael Osso, president, CEO, Crohn's & Colitis Foundation, in a press release. "Despite our progress in IBD research and treatment options, many patients still struggle to access the care they need without facing undue burden. Our survey findings highlight the critical need for reforms to ensure that IBD patients can access the medications they need without undue financial hardship."²

While there were a number of strengths associated with the study, such as the large number of respondents and high inclusion of many patients on advanced therapy, the authors acknowledged that there were also a number of limitations. First, the population wasn’t considered to be very diverse. Additionally, data about the prevalence of IBD among the US population is limited and difficult to determine due to the United States lacking a unified health system or central health database. However, the authors noted that their survey wasn’t an example of the entire IBD population in the United States.¹

“Future surveys should also focus on other evolving trends within healthcare, such as copay accumulators, maximizer plans, and increasing biosimilar availability, which are influencing IBD-related costs and access,” stated the authors of the study. “In addition, future directions also include identifying how to increase response rates and diversity of respondents with future surveys and may be further guided by engaging with more communities and organizations that serve rural, urban, and diverse populations as well as focus groups with minority IBD patients.”

The authors concluded that despite a number of advancements within IBD, patients with IBD continue to experience challenges accessing healthcare, including medications, treatments, and healthcare professionals. Due to the high costs of treatment, patients and their families make a number of challenging financial decisions, including taking less of their medication than prescribed or putting off major household purchases, to afford their healthcare costs. The authors suggest that moving forward, awareness and advocacy efforts focused on healthcare system reform, achieving health equity, and policies to further minimize care disparities and barriers remain vital.¹

References

1. Healthcare Access for Patients With Inflammatory Bowel Disease in the United States: A Survey by the Crohn’s & Colitis Foundation. Oxford Academic. October 8, 2024. Accessed October 9, 2024. https://academic.oup.com/ibdjournal/advance-article/doi/10.1093/ibd/izae237/7811812

2. Crohn's & Colitis Foundation survey reveals more than 40% of IBD patients made significant financial sacrifices to pay for their healthcare. EurekAlert! October 8, 2024. Accessed October 9, 2024. https://www.eurekalert.org/news-releases/1060488