With around 270,000 individuals currently affected by irritable bowel disease, Canada has the highest prevalence in the world, according to Mina Mawani, president and chief executive officer of Crohn’s and Colitis Canada, during a session at Benefits Canada’s 2019 Halifax Benefits Summit on Sept. 24.
“And this is going to increase significantly. We’re going to be at 400,000 cases by the time we’re at 2030, which is one per cent of Canada’s population.”
Currently, more than 7,000 children and youth are living with IBD in Canada, she said, which is a 50 per cent increase over the last 10 years. As possible reasons for this increase, Mawani highlighted the greater availability of pediatric IBD specialists in Canada and changes in the environment. However, one in every 160 individuals over the age of 65 living in Canada has IBD, she added, noting seniors are the fastest growing group of people living with Crohn’s or colitis. “This is going to be a huge problem for patients, caregivers and the health-care system.”
Mawani also noted quality of life is significantly lower for individuals with IBD. It’s harder for them to pursue employment, family planning and personal milestones. In fact, people experiencing IBD symptoms and their caregivers are more likely to require time off work — or they’re likely to be at work, but not really productive, she added. “Forty-six per cent of people are going to be more absent with IBD at work than your normal population.”
Due to caregiver, short- and long-term work loss, the cost of IBD in Canada is $1.29 billion, she noted. “We’re looking at a lot of dollars in the health-care system that are lost due to this chronic illness.”
So how can employers support employees with IBD? Mawani suggested they make sure people have access to a washroom close by and without any barriers to entry, like access codes. Working at home policies are also important for this patient population, she added.
Mawani also discussed how the availability of biologics and biosimilars have led to policy decisions, including non-medical switching from a biologic to a biosimilar, which is impacting Crohn’s and colitis patients.
“If you’re newly diagnosed, we’re supportive of you going on a biosimilar. But if you’re on a biologic, why be switched to a biosimilar? We understand the health-care cost containment pressure on the health-care system; we’re willing to support those pressures. But biologic manufacturers have proposed significant savings — almost matching, matching or even below the price of biosimilars.
“From a patient perspective, we don’t understand why patients are being forced to switch because, initially, the argument was all about cost savings.”
Further, in Canada, there’s been a “nocebo” effect, said Mawani. For instance, when a patient is being switched, they’re aware of it, which leads some to feel as though another medication won’t work for them.
The decision to switch a patient from a biologic drug to its biosimilar should be based on patient-doctor choice, she added, noting that, if a person had a chronic illness, wouldn’t they want to be in control of their own disease?
“Awareness needs to be built for the IBD population. Employers, benefits advisors, everyone needs to understand how impactful and chronic these diseases are for this patient population and how you can help them have a better quality of life.”
Read more stories from the 2019 Halifax Benefits Summit.