A study conducted by researchers at UT Southwestern University found that patients with inflammatory bowel disease (IBD) who needed treatment with biological therapies and enrolled in a financial assistance program were less likely to need surgery after starting treatment compared to those not enrolled in the program.
There are gaps in the care of patients with IBD. Our project indicated that providing biological therapy to IBD patients through a financial assistance program would have better outcomes compared to patients with a delay in receiving treatment.”
Moheb Qatar, MD, assistant professor of internal medicine in UTSW’s division of gastroenterology and hepatology and lead author
Low socioeconomic status is a known risk factor for poor health outcomes and overuse of healthcare resources in many chronic diseases. Financial assistance programs are designed to improve health care for patients of low socioeconomic status by reducing the costs of medical services.
For patients with an inflammatory bowel disease, 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 significant implications for overall outcomes.
The study published in Pathophysiology, the medical records of destitute IBD patients treated at Parkland Health were used to assess the impact of financial assistance programs on health care outcomes and resource use. The “safety net” hospital program provides indigent patients with access to medicines at deep discounts without the need for authorization from medical insurance companies.
Adult patients who started a new biologic therapy to treat IBD between January 2010 and January 2019 were included in the study. The researchers classified patients according to whether they were enrolled in a financial assistance program or covered by private or government insurance.
Compared to insured patients, patients enrolled in the program were less likely to have surgery. This was held even when accounting for variables such as age, gender, ethnicity, and disease complexity/severity.
Interestingly, patients receiving financial assistance also underwent more imaging studies before surgery was needed than patients not undergoing the program. The researchers believe this may be due in part to the ease of access to required scans due to insurance permission and the lack of co-payments. Access to imaging may explain the need for fewer surgeries, as these studies can be used to modify treatment regimens. However, additional studies are needed to fully explore these possibilities as well as whether enrollment in a financial assistance program reduces overall disease severity.
Dr. Baktour said that providing uninterrupted treatment for IBD reduces complications and achieves a normal quality of life for patients. Programs between health care systems and drug companies could fill such gaps in health care management for patients with inflammatory bowel disease and other chronic diseases.
Other USSW researchers who contributed to this study include Philip Guo, Andrew Gilman, Christopher Chang, David I. Fodman, and Ezra Burstein. Elisabeth Moss of Ambulatory Care Pharmacy at Parkland Health also contributed.