Variations in Health Insurance Policies Regarding Biologic Therapy Use in Inflammatory Bowel Disease

Abstract

The majority of the policies reviewed fail to adhere to the current AGA pathway recommendations for ulcerative colitis and CD. Further interventions are needed to better align policies with optimal evidence-based drug therapy.

Ulcerative Colitis

“…The choice of which drug to add depends on disease severity, patient preference, and insurance policies. 3,63 Corticosteroids are utilized in most cases, often oral prednisone. However, in up to 15% of cases, acute severe UC develops, necessitating hospitalization and use of IV corticosteroids.…”

“…However, insurance policies often require step-therapy failures before approval of biologics, and insurance companies may also have preferred biologics that determine which agent is selected. 63 Corticosteroids. Corticosteroids are only used for the induction of remission.…”

“…88 In general, the choice of which anti-TNF to initiate depends on the underlying severity of the inflammation, with more severe cases benefiting most from infliximab, insurance policies and preferred anti-TNF agents, and patient preference for infusions or selfinjections. 63 Two infliximab biosimilars (infliximab dyyb and infliximab abda) are approved to treat UC. Their efficacy is similar to that of infliximab.…”

New steps in infliximab therapeutic drug monitoring in patients with inflammatory bowel diseases

“…Despite improvement in clinical outcome, loss of response to anti‐TNF‐α Mabs remains a major concern in the management of IBD patients. Increasing evidences suggested that therapeutic drug monitoring (TDM) of anti‐TNF‐α Mabs could help to improve remission rate or mucosal healing achievement but the clinical interest of TDM of anti‐TNFα Mabs in IBD patients remains to be further demonstrated . One of the limitations lies in the absence of standardization of the analytical methods used to measure IFX plasma concentration.…”

Visceral Fat Is Increased in Individuals With Crohn’s Disease: A Comparative Analysis With Healthy Controls

“…Antitumor necrosis factor (anti-TNF) agents are effective drugs for inducing and maintaining remission in IBD and its use may be associated with weight gain (7) . The interplay between obesity and IBD is complex and poorly understood.…”