Spending Wisely on IBD Medications

An IBD Medical Therapy
Economic Thought Experiment

Somewhere between 33-50% of patients with Crohn’s disease are prescribed 5-ASA medications like Pentasa.

Thanks to Vip Jairath for the estimates here click here to read about the estimates

And about 246.7 persons per 100,000 in the US has Crohn’s disease. Among 320 million people in the US, that works out to be 789,440 people with Crohn’s disease.

Thanks to Ed Loftus for the numbers. See the link for yourself here to read the details.

So, over 250,000 (possibly as many as 395K) Americans take 5-ASA medications for Crohn’s disease. That would be fine, but 5-ASA medications are not FDA approved for the treatment of Crohn’s disease.

Is this just an FDA oddity that these 5-ASA drugs are not approved for Crohn’s disease? What does the evidence tell us?

This Cochrane review states there is “no evidence in this review to suggest that oral 5-ASA preparations are superior to placebo for the maintenance of medically-induced remission in patients with Crohn’s disease.”

You can read the full review at this link

OK, so lots of caregivers in the US are prescribing unapproved 5-ASA medicines to patients with Crohn’s disease, despite the lack of evidence that they work any better than placebo. We are wasting money on a medication that is no better than placebo.

But how much money?

At 250,000+ people a year, that could be a lot. But it depends on the price of 5-ASA medications. They’ve been around for a long time, & they are simple derivatives of aspirin. They’re probably pretty cheap, right?

Fortunately, GoodRx can help us comparison shop. Note that they state that this medication is for ulcerative colitis (not Crohn’s disease)

Good news! We can get a month’s worth of Pentasa for only US$1,451 at Costco! For a year, this would run US$17,412 per person. And for (a low estimate of) 250,000 people, this costs the US healthcare system and insurers US$4.353 billion each year

For no measurable benefit. Let that sink in.

So the next time a health insurer tells you they can’t cover an FDA-approved medication for your #IBD, tell them you know how they can pay for it.

Stop paying for 5-ASAs for Crohn’s disease.
Easy savings!

And just in case this is like finding a bug in Google software, for any health insurers that want to send the 0.1% finder’s fee for saving $4.3 billion dollars per year,the address is:

IBD Research Fund
SPC 5682
1500 Medical Center Drive
University of Michigan
Ann Arbor, MI, 48109