Drs Peter Higgins and Frank Scott discuss the challenges of delays in care for patients with Crohn's disease, how insurance denials and delays harm patients, and what doctors can do to help.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/967624). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Specialty Drug Coverage Varies Across Commercial Health Plans in the US https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.1553

2021 AMA Prior Authorization (PA) Physician Survey https://www.ama-assn.org/system/files/prior-authorization-survey.pdf

Corticosteroid Use and Complications in a US Inflammatory Bowel Disease Cohort https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918923/

Increased Risk of Venous Thromboembolic Events With Corticosteroid vs Biologic Therapy for Inflammatory Bowel Disease https://www.cghjournal.org/article/S1542-3565(14)01045-3/fulltext

Impact of Prior Authorization of Antiepileptic Drugs in Children With Epilepsy https://www.pedneur.com/article/S0887-8994(18)30151-6/fulltext

Prior Authorization Delays Biologic Initiation and Is Associated With a Risk of Asthma Exacerbations https://pubmed.ncbi.nlm.nih.gov/33404389/

Treatment Delays Associated With Prior Authorization for Infusible Medications: A Cohort Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062557/

Delays Related to Prior Authorization in Inflammatory Bowel Disease https://publications.aap.org/pediatrics/article/149/3/e2021052501/184867/Delays-Related-to-Prior-Authorization-in

What Is the Role of Fecal Calprotectin Levels in the Diagnosis of Inflammatory Bowel Disease (IBD)? https://www.medscape.com/answers/179037-54913/what-is-the-role-of-fecal-calprotectin-levels-in-the-diagnosis-of-inflammatory-bowel-disease-ibd

Variation In Use and Content of Prescription Drug Step Therapy Protocols, Within and Across Health Plans https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00822?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

What Is Step Therapy/Fail First? https://www.crohnscolitisfoundation.org/get-involved/be-an-advocate/steptherapy

H.R. 2163 – Safe Step Act https://www.congress.gov/bill/117th-congress/house-bill/2163

Step Therapy's Balancing Act — Protecting Patients While Addressing High Drug Prices https://www.nejm.org/doi/10.1056/NEJMp2117582?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Battle Heats up Over Bill on "Step Therapy," Drug Rebates https://www.coloradopolitics.com/legislature/battle-heats-up-over-bill-on-step-therapy-drug-rebates/article_0f6e56c4-c0b8-11ec-9ead-47fa6f99ac6e.html

Crohn Disease Pathology https://emedicine.medscape.com/article/1986158-overview#a6