Advanced Therapies for Inflammatory Bowel Disease: Navigating Payor and Financial Challenges

被引：3

作者：

Whitmire N. ^{[1
]}

Schlueter M. ^{[1
]}

Kirkpatrick M. ^{[1
]}

机构：

[1] Division of Gastroenterology, UC San Diego Health, 9350 Campus Pt Dr Ste 2B, La Jolla, 92037, CA

来源：

Current Gastroenterology Reports | 2024年 / 26卷 / 3期

关键词：

Biologics; Inflammatory bowel disease; Inflammatory bowel disease therapies; appeal process; Medicare; Medication prior authorization;

D O I：

10.1007/s11894-024-00916-w

中图分类号：

学科分类号：

摘要：

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. © The Author(s) 2024.

引用

页码：68 / 76

页数：8

共 27 条

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