Addressing Disparities in IBD Care to Reduce Costs and Improve Access

Making the cost of inflammatory bowel disease (IBD) care sustainable requires improving access to cost-effective treatments, increasing biosimilar uptake, and implementing multidisciplinary care strategies to reduce both direct and indirect expenses, according to a recent review.

Biosimilars offer cost-saving potential for patients with IBD but face adoption barriers in the US, including delayed approvals, patent thickets, and payer incentives favoring originators. | Image credit: Aliaksandr Marko - stock.adobe.com

The review, published in Clinical Gastroenterology and Hepatology, encompassed the current landscape of IBD care, highlighting challenges with achieving cost sustainability in the space as well as access and affordability disparities.

Direct costs associated with IBD care include expenses related to physician visits, emergency care, hospitalizations, surgeries, diagnostics, medications, and supportive therapies. The annual per-person cost of these services varies by region, with estimates around $9000 to $12,000 in high-income countries, between $1000 and $4000 in middle-income nations, and $200 to $800 in low-income countries.

Although hospitalization costs historically dominated IBD expenses, the rise of biologic therapies has shifted the cost burden to medications, particularly in the US, where drug prices remain significantly higher due to market dynamics and a lack of regulation. Despite the rise in effective treatments correlating with reduced hospitalizations, the cost per admission continues to rise, driven by inflation, disease complexity, and the need for newer therapies.

“Addressing the increasing financial burden of IBD requires a comprehensive approach that tackles disparities, enhances access to cost-effective therapeutics, and promotes collaborative efforts across health care systems. Embracing innovative strategies can pave the way for personalized, cost-effective care accessible to all individuals with IBD, ensuring better outcomes and sustainability,” the authors wrote.

Socioeconomic and racial inequities lead to delayed treatment, higher hospitalizations, and worse outcomes. Geographic disparities and insurance barriers further limit access to biologics, increasing health care costs.

Early biologic therapy can reduce long-term complications, but high costs and restrictive insurance policies hinder widespread use. Countries with robust health care policies, like Denmark, have achieved cost savings through early biologic use, while the US faces inefficiencies due to limited price negotiations and fragmented insurance systems.

Biosimilars offer cost-saving potential but face adoption barriers in the US, including delayed approvals, patent thickets, and payer incentives favoring originators. Europe has successfully integrated biosimilars and reduced costs, but US uptake remains inconsistent between markets 10 years in, with the rheumatic and gastroenterology spaces among those where biosimilars are struggling.2

To improve cost sustainability, reforms must ensure equitable access, promote biosimilar adoption, and streamline insurance policies to support high-value care.1 Addressing disparities and optimizing treatment strategies will be key to controlling IBD health care costs.

References

1. Burisch J, Claytor J, Hernandez I, Hou JK, Kaplan GG. The cost of inflammatory bowel disease care: how to make it sustainable. Clin Gastroenterol Hepatol. 2025;23(3):386-395. doi:10.1016/j.cgh.2024.06.049

2. Jeremias S. From Amjevita to Zarxio: a decade of US biosimilar approvals. The Center for Biosimilars®. March 6, 2025. Accessed March 11, 2025. https://www.centerforbiosimilars.com/view/from-amjevita-to-zarxio-a-decade-of-us-biosimilar-approvals