Healthcare Access for Patients with Inflammatory Bowel Disease in the United States
A Survey Collaboration with the Crohn’s & Colitis Foundation
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Key Findings
- Insurance Barriers to Care: 56% of patients on prescribed IBD medications faced insurance issues accessing them, with those on advanced specialty medications, younger patients, or those with employer insurance being significantly affected.
- Medication Delays and Step Therapy: 12% couldn’t get medications, and 17% experienced significant delays, leading to adverse health events (69%). Step therapy mandates affected 25% of patients, with 85% reporting negative health outcomes.
- Financial Barriers to Care: 24% struggled to pay IBD-related bills, and 41% reported financial trade-offs, especially those on advanced specialty medications or living in poverty.
- Coverage for Tests and Treatments: 20% of respondents faced difficulties with insurance covering necessary tests or treatments, especially those on specialty medications or under 65 being most affected.
Background
A prior survey disseminated in 2017 identified that healthcare access barriers exist and significantly affect patients with inflammatory bowel disease (IBD). We sought to identify, through an updated survey, the healthcare access barriers that patients continue to face, with a focus on socioeconomic factors and patient awareness of resources to navigate existing barriers.
Methods
A 52-question online survey evaluating (1) access to healthcare professionals, medications, and procedures, (2) associated financial challenges, and (3) patient awareness of education and advocacy tools to navigate IBD care barriers, was disseminated through multiple channels to IBD patients and their caregivers.
Results
Of the 2,281 completed responses, patients on advanced specialty medications, younger than 65 years of age, or on employer insurance experienced significantly greater issues with insurance barriers to accessing medications and coverage of medically necessary tests/treatments. Patients who live in areas of concentrated poverty were more likely to experience poor health outcomes when subjected to step therapy compared to patients who did not. Additionally, patients were more likely to experience one or more financial barriers or tradeoffs if the patient used an advanced specialty medicine or lived in an area with concentrated poverty.
Conclusions
While there have been significant and numerous advancements in IBD treatments, patients with IBD continue to experience barriers to healthcare access and treatment and financial struggles. Ongoing awareness and advocacy efforts focused on healthcare system reform and related policies to further minimize care disparities and barriers remain vital.
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