Therapeutic drug monitoring is increasingly performed to optimize biologic therapy in inflammatory bowel disease (IBD).
However, patients and physicians may be reluctant to perform therapeutic drug monitoring due to concerns related to potential out-of-pocket costs.
Dr James Campbell and colleagues evaluated patient understanding and attitudes toward therapeutic drug monitoring in different clinical scenarios with and without potential out-of-pocket costs.
Adult IBD patients at a tertiary gastroenterology clinic were anonymously surveyed from 2016 to assess their understanding of and willingness to undergo therapeutic drug monitoring in a variety of clinical scenarios, both with and without a potential out-of-pocket cost.
Responses were analyzed for associations with changes in attitudes if out-of-pocket costs were involved.
|68% were aware of or had previously undergone therapeutic drug monitoring |
|Digestive Diseases & Sciences|
Of 118 completed surveys, the team found that 68% of patients were aware of or had previously undergone therapeutic drug monitoring.
The researchers noted that patient willingness to undergo therapeutic drug monitoring was high both with and without potential out-of-pocket costs.
However, patients were significantly less willing with out-of-pocket cost.
The team observed that higher disease-related quality of life scores, as measured by the short inflammatory bowel disease questionnaire (SIBDQ), was significantly associated with an increased willingness to assume a potential out-of-pocket cost.
Dr Campbell's team commented, "Overall, patients understand and are willing to undergo therapeutic drug monitoring in certain potentially beneficial clinical scenarios, however, are significantly less willing if paying out-of-pocket."
"A higher SIBDQ score was associated with an increase in willingness to undergo therapeutic drug monitoring when out-of-pocket cost was involved."
"Physicians should discuss therapeutic drug monitoring with their patients in order to make an informed and personalized treatment decision."