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Queiroz NSF, Martins CDA, Quaresma AB, Olivera Sendra PA, Ernest-Suarez K, Kotze PG. IBD barriers across the continents: a continent-specific analysis: Latin America. Therap Adv Gastroenterol 2023; 16:17562848231167953. [PMID: 37124371 PMCID: PMC10134129 DOI: 10.1177/17562848231167953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Latin America (LATAM) is a large region comprising 47 countries and territories. Each one carries a different cultural and historical background, diverse political systems, and a particular approach to healthcare management. There is a lack of high-quality data on the epidemiology of inflammatory bowel diseases (IBD) in this region, including broad and detailed information about the penetration of biological and advanced therapies as treatment strategies. From an IBD perspective, patients experience, in general, fragmentations and inequities in the healthcare systems, with different and usually delayed access to qualified health services. This review explores the barriers to accessing IBD care throughout LATAM. The authors compiled data from multiple sources, such as studies focusing on epidemiology, biological penetration, and surgical rates. In addition, overall access to IBD treatments was assessed through a questionnaire distributed to physicians in LATAM via email and direct messaging to capture local perspectives.
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Affiliation(s)
| | | | - Abel Botelho Quaresma
- Health Sciences Graduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, Brazil
| | - Pablo A. Olivera Sendra
- IBD Unit, Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina
- Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Kenneth Ernest-Suarez
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hospital México, Caja Costarricense de Seguro Social, San José, Costa Rica
- Gastroenterology Postgraduate Program, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Paulo Gustavo Kotze
- Health Sciences Graduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- IBD Outpatient Clinics, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
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Gil F, Juliao-Baños F, Amador L, Castano N, Reyes JM. Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia. Pharmacoecon Open 2022; 6:837-846. [PMID: 35943702 PMCID: PMC9596638 DOI: 10.1007/s41669-022-00360-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the cost effectiveness of tofacitinib versus other treatment options currently available in Colombia in naïve to biologics (first-line) and exposed to biologics (second-line) patients with moderate to severe active ulcerative colitis (UC). METHODS A Markov model was constructed with 8-week cycles, simulating a cohort of patients in a 5-year time horizon. The health states included remission, treatment response, active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis, and effectiveness was measured using quality-adjusted life-years (QALYs). Unit costs were derived from official national sources. RESULTS For first line, the incremental cost-effectiveness ratio (ICER) per QALY was $883 for tofacitinib and $3619 for infliximab, compared with adalimumab. Sensitivity analysis showed that tofacitinib is cost effective in 45% of the iterations, adalimumab in 5%, and infliximab in 50%. Meanwhile, the ICER of adalimumab was $14,927 compared with tofacitinib in second-line treatment. In the sensitivity analysis, tofacitinib was cost effective in 64% of the iterations, followed by adalimumab in 36%. Infliximab and golimumab were not included due to data limitations in the network meta-analysis of second-line treatment. CONCLUSION The analysis suggests that in Colombia, treatment with tofacitinib for patients with moderate-to-severe UC is a cost-effective option in both lines compared with other treatment options.
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Affiliation(s)
| | | | - Luisa Amador
- Pfizer SAS, Av. Suba #95-66, 112111, Bogotá, Colombia
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Balderramo D, Trakal J, Herrera Najum P, Vivas M, Gonzalez R, Benavidez A, López Villa D, Daino D, Raiden K, Germán A, Corzo MA, Ponce de León J, Ferrer L, Germán C, Bálzola S, Idoeta A, Zárate F, Defagó MR. High ulcerative colitis and Crohn's disease ratio in a population-based registry from Córdoba, Argentina. Dig Liver Dis 2021; 53:852-857. [PMID: 33531211 DOI: 10.1016/j.dld.2021.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/09/2021] [Accepted: 01/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Few studies have described the epidemiology and clinical behavior of inflammatory bowel disease (IBD) in South America. The aim of this study was to report on the prevalence, phenotype, and treatment of patients with IBD diagnosis in Capital Department of the Province of Córdoba, Argentina. METHODS Data from adult patients (≥ 18 years-old) with IBD diagnosis that attended 12 public or private centers between 05/2014 and 05/2019 were included in a common registry. RESULTS A total of 655 patients were included (females: 53.4%). The ratio of ulcerative colitis (UC) (n = 561) to Crohn's disease (CD) (n = 88) was 6.38, with age-adjusted IBD prevalence being 70.1 (95% confidence interval 70.08-70.12) cases/100,000 habitants. Extraintestinal manifestations were diagnosed in 22.8% of patients, and left-side colitis (46%) was the most frequent extension in UC patients. In CD patients, colonic involvement (55.7%) and non-stricturing/non-penetrating behavior (74%) were the most frequent presentations. Biologic therapy was used in 36.4% of CD patients and 9.1% of UC patients (P<0.001). CONCLUSION In this population registry study, IBD prevalence was similar to that reported in other series in the region. A higher UC/CD ratio was observed due to the lower prevalence of CD compared to similar studies in South America.
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Affiliation(s)
- Domingo Balderramo
- Gastroenterology Department, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, Córdoba CP 5016, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina; Hospital Raúl Ferreyra, Córdoba, Argentina.
| | - Juan Trakal
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina
| | | | | | - Roxana Gonzalez
- Gastroenterology Department, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, Córdoba CP 5016, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina; Hospital Raúl Ferreyra, Córdoba, Argentina
| | - Analía Benavidez
- Gastroenterology Department, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, Córdoba CP 5016, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina; Hospital Raúl Ferreyra, Córdoba, Argentina
| | | | - Diego Daino
- Sanatorio Allende, Córdoba, Argentina; Humana-Instituto Médico, Córdoba, Argentina
| | | | | | | | | | - Luciana Ferrer
- Instituto Modelo de Cardiología, Córdoba, Argentina; Humana-Instituto Médico, Córdoba, Argentina; Instituto Conci Carpinella, Córdoba, Argentina; Nuevo Hospital San Roque, Córdoba, Argentina
| | - Carlos Germán
- Instituto Modelo de Cardiología, Córdoba, Argentina; Instituto Conci Carpinella, Córdoba, Argentina; Centro de Diagnóstico Marchegiani, Córdoba, Argentina
| | | | - Adriana Idoeta
- Nuevo Hospital San Roque, Córdoba, Argentina; Hospital Rawson, Córdoba, Argentina
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