AGA: ‘We must work together’ to alleviate barriers, improve care for patients with IBD
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Key takeaways:
- The AGA’s 12-point plan aims to improve care among patients with inflammatory bowel disease.
- Combatting barriers to care requires collaboration across the health care community, insurers and legislators.
A 12-point plan from the AGA proposed ways in which collaboration between the health care community, insurers, pharmaceutical companies and legislators can improve “fixable problems” affecting patients with inflammatory bowel disease.
“Unaffordable drug costs, step therapy and other insurer-mandated barriers are fixable problems,” M. Anthony Sofia, MD, co-first author and IBD specialist at Oregon Health & Science University, said in a related AGA press release. “Every day, we see people who have been harmed by delayed and inadequate care. Solving these barriers would lift an unimaginable weight off our patients’ shoulders and allow them to lead healthier lives.”
He added: “We must work together to collaborate on solutions to strengthen and advance the care for all people with IBD.”
According to results from an AGA survey, barriers to care are a “high priority concern” among the association’s members and include:
- restricted access to treatment through prior authorization and step therapy;
- prohibitive drug costs;
- forced nonmedical switching;
- coverage gaps in disease monitoring;
- inadequate coverage for multidisciplinary care;
- limited access to specialists; and
- intersecting identities leading to inequality.
In a white paper published in Clinical Gastroenterology and Hepatology, a group that included experts, a patient advocate and private practitioners reviewed these obstacles, identified priorities and developed solutions for advocacy in IBD care.
Improvement opportunities were outlined in a 12-point plan and include:
- Experiences and insights from patients and expert clinicians should be reflected in data and research.
- Insurers should cover holistic, multidisciplinary care and all necessary disease activity and drug level monitoring, which will ensure patients are able to achieve treat-to-target outcomes.
- Payers should publish denial and appeals data to ensure transparency and accountability.
- Support for patient education programs to improve health literacy and improve patient access to expert IBD care, including flexible delivery models for underserved populations.
- Move beyond insurer-mandated step therapy and fail first policies.
- Engage pharmaceutical partners to develop equitable programs that address prohibitive drug costs and expand patient access/support.
- Continue to advocate for equitable access to therapy for patients with Medicare and Medicaid.
“There are many essential partners in the cycle of care whose coordination is required for this to take place, including a diversity of health care providers, insurers both private and public, pharmaceutical colleagues and legislators,” Sofia and colleagues wrote in the paper. “The imperative falls on all of us to work together collaborate and innovate solutions to strengthen and advance the care for all people with IBD.”
Reference:
- AGA announces 12-point plan to improve the care of all patients with inflammatory bowel disease. https://gastro.org/press-releases/aga-12-point-plan-improve-ibd-care/. Published Feb. 28, 2024. Accessed March 04, 2024.
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