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Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases

Background and aims: Brazilian patients with inflammatory bowel diseases (IBD) requiring therapy with biological agents usually have access to medicines through the National Unified Health Care System (SUS). This study aimed to analyze Brazilian IBD patient perception regarding access (availability...

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Autores principales: Parra, Rogerio Serafim, da Costa Ferreira, Sandro, Machado, Vanessa Foresto, Nigro, Cintia Maura Caseiro, da Rocha, José Joaquim Ribeiro, de Almeida Troncon, Luiz Ernesto, Feres, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095198/
https://www.ncbi.nlm.nih.gov/pubmed/37048755
http://dx.doi.org/10.3390/jcm12072672
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author Parra, Rogerio Serafim
da Costa Ferreira, Sandro
Machado, Vanessa Foresto
Nigro, Cintia Maura Caseiro
da Rocha, José Joaquim Ribeiro
de Almeida Troncon, Luiz Ernesto
Feres, Omar
author_facet Parra, Rogerio Serafim
da Costa Ferreira, Sandro
Machado, Vanessa Foresto
Nigro, Cintia Maura Caseiro
da Rocha, José Joaquim Ribeiro
de Almeida Troncon, Luiz Ernesto
Feres, Omar
author_sort Parra, Rogerio Serafim
collection PubMed
description Background and aims: Brazilian patients with inflammatory bowel diseases (IBD) requiring therapy with biological agents usually have access to medicines through the National Unified Health Care System (SUS). This study aimed to analyze Brazilian IBD patient perception regarding access (availability and provision quality) to high-cost drugs in the public health care system. Methods: A questionnaire-based survey was carried out in an IBD referral center in Brazil. All adult patients with an established diagnosis of ulcerative colitis (UC) or Crohn’s disease (CD) that use biological therapy were invited to participate. Data were collected on the biological in use, lack of distribution (number of absences, average time to regularization, impairment in patient treatment), and difficulties reported by patients in obtaining the drugs. Results: Overall, 205 patients met the inclusion criteria and answered the questionnaire. Most of the patients had CD (n = 161, 78.5%), nearly half of them (n = 104, 50.7%) were female; 87 patients (42.4%) were unemployed, and of these, 40 patients (19.5%) had government assistance as the main source of income. Regarding the medications used, infliximab (n = 128, 62.5%) was the most used medication, followed by adalimumab (n = 39, 19.0%). Most patients (n = 172, 83.9%) reported at least one failed delivery of biological medicine in the last year, with a single shortage in forty-two patients (24.4%), at least two shortages in forty-seven patients (27.3%), and three or more shortages in seventy-eight patients (45.3%). The average time to regularize the distribution was up to 1 month in 44 cases (25.6%), up to 2 months in 64 cases (37.2%), and more than 3 months in 56 patients (32.6%). Among patients who reported delays, 101 patients (58.7%) felt that it may have impaired their treatment. Conclusion: Brazilian IBD patients reported high rates of failure to dispense biological drugs by the national healthcare system within one year. Our data highlight the need for improvement in this system for the correct supply of medication to avoid treatment failure and relapse.
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spelling pubmed-100951982023-04-13 Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases Parra, Rogerio Serafim da Costa Ferreira, Sandro Machado, Vanessa Foresto Nigro, Cintia Maura Caseiro da Rocha, José Joaquim Ribeiro de Almeida Troncon, Luiz Ernesto Feres, Omar J Clin Med Article Background and aims: Brazilian patients with inflammatory bowel diseases (IBD) requiring therapy with biological agents usually have access to medicines through the National Unified Health Care System (SUS). This study aimed to analyze Brazilian IBD patient perception regarding access (availability and provision quality) to high-cost drugs in the public health care system. Methods: A questionnaire-based survey was carried out in an IBD referral center in Brazil. All adult patients with an established diagnosis of ulcerative colitis (UC) or Crohn’s disease (CD) that use biological therapy were invited to participate. Data were collected on the biological in use, lack of distribution (number of absences, average time to regularization, impairment in patient treatment), and difficulties reported by patients in obtaining the drugs. Results: Overall, 205 patients met the inclusion criteria and answered the questionnaire. Most of the patients had CD (n = 161, 78.5%), nearly half of them (n = 104, 50.7%) were female; 87 patients (42.4%) were unemployed, and of these, 40 patients (19.5%) had government assistance as the main source of income. Regarding the medications used, infliximab (n = 128, 62.5%) was the most used medication, followed by adalimumab (n = 39, 19.0%). Most patients (n = 172, 83.9%) reported at least one failed delivery of biological medicine in the last year, with a single shortage in forty-two patients (24.4%), at least two shortages in forty-seven patients (27.3%), and three or more shortages in seventy-eight patients (45.3%). The average time to regularize the distribution was up to 1 month in 44 cases (25.6%), up to 2 months in 64 cases (37.2%), and more than 3 months in 56 patients (32.6%). Among patients who reported delays, 101 patients (58.7%) felt that it may have impaired their treatment. Conclusion: Brazilian IBD patients reported high rates of failure to dispense biological drugs by the national healthcare system within one year. Our data highlight the need for improvement in this system for the correct supply of medication to avoid treatment failure and relapse. MDPI 2023-04-03 /pmc/articles/PMC10095198/ /pubmed/37048755 http://dx.doi.org/10.3390/jcm12072672 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Parra, Rogerio Serafim
da Costa Ferreira, Sandro
Machado, Vanessa Foresto
Nigro, Cintia Maura Caseiro
da Rocha, José Joaquim Ribeiro
de Almeida Troncon, Luiz Ernesto
Feres, Omar
Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title_full Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title_fullStr Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title_full_unstemmed Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title_short Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases
title_sort access to high-cost biological agents: perceptions of brazilian patients with inflammatory bowel diseases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095198/
https://www.ncbi.nlm.nih.gov/pubmed/37048755
http://dx.doi.org/10.3390/jcm12072672
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