Author:
Whitmire Natalie,Schlueter Michelle,Kirkpatrick Melissa
Abstract
Abstract
Purpose of Review
In the United Sates the cost of managing Crohn’s disease and ulcerative colitis, the two most common inflammatory bowel diseases, is a major factor that can alter the course of treatment. The increasing use of advanced therapies such as biologics and oral small molecules is a driver of these costs. Many IBD providers find navigating the payor and non-insurance cost assistance processes to be a significant challenge in care management. We aim to clarify these processes and provide an outline for success.
Recent Findings
Insurance companies use various processes to manage medication costs and while they may not ultimately be cost-effective, the processes have continued and are increasingly complex. This complexity has led to measurable delays in care and negative outcomes.
Summary
With a deeper understanding of payor and non-insurance cost-assistance processes we have developed a workflow for navigating the use of advanced therapies in the treatment of IBD.
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
Reference28 articles.
1. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769–78.
2. Baumgart DC, Carding SR. Inflammatory bowel disease: cause and immunobiology. Lancet. 2007;369:1627–40.
3. Chang AY, Cowling K, Micah AE, et al. Global Burden of Disease Health Financing Collaborator Network. Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050. Lancet. 2019;393(10187):2233–60.
4. Papanicolas I, Woskie LR, Jha AK. Health Care Spending in the United States and Other High-Income Countries. JAMA. 2018;319(10):1024–39.
5. Health Affairs Council on Health Care Spending and Value. A road map for action: recommendations of the Health Affairs Council on Health Care Spending and Value. Health Affairs [Internet]; 2023 [cited 2023 Oct 25]. https://www.healthaffairs.org/r/healthspending/health-affairs-spending-council-report.pdf.