Intestinal diseases: “Less costs and absences from work with doctor-patient dialogue”

For the physician, what matters most is that the patient with chronic inflammatory bowel disease (IBD) is treated by a trained professional and can easily access predictable, shared and standardized care. For the patient, the most important thing is to be welcomed and supported in a shared care path suited to their needs. Two distant planets, speaking different languages. Clearing the distances and finding a way of dialogue has not only advantages in terms of adherence to therapies and improvement of the quality of life (especially for young patients struggling with the difficulty of accepting the disease), but also economic implications. A recent survey “found that only 11% of physicians actively involved patients in the care pathway. Crossing this data with cost data, it emerged that if the physician actively involves the patient in the care pathway, there is a direct cost saving of 20% and a percentage of absence from work of less than 25% “, reports Salvo Leone, general manager of the Amici Onlus association, today during the ‘Made for freedom’ event, promoted by Takeda, which lights up the spotlight on the unmet needs of patients and on the flexibility of therapies: a concept that is also presented in relation to the new subcutaneous formulation of the monoclonal antibody vedolizumab, a biotechnological drug with intestinal selectivity, already available in intravenous formulation for the treatment of adult patients with moderate to severe active ulcerative colitis or Crohn’s disease. “If the doctor spends time interacting with the patient, there is also a containment of direct costs, as well as an improvement in the quality of life”, underlines Leone who also brings another data: “It emerged from another survey that 11% of patients stop the treatment and do not tell the doctor. If we add another 13% who stop and communicate it, we arrive at one in 4 patients (out of a sample of 500 interviewees) “who stops taking care. And this is seen by the CEO of Amici as “a failure of the therapeutic alliance”. “The first point is adherence to therapies”, continues Leone. “If there are innovations that can make life easier for our patients in the near future, they are always welcome”, reflects Alessandro Armuzzi, Agostino Gemelli University Hospital – Irccs of Rome, professor of Gastroenterology at the Catholic University. We talk about “making our patients more free with the same effectiveness, being flexible with the same type of therapy. These are positive things. And one thing is to see the results of a registration trial, one thing is to see on a large scale what it really happens in clinics “.” We doctors – adds Ambrogio Orlando, Villa Sofia Cervello hospital, Palermo – must make an effort to try to satisfy the unmet needs of patients more and more, share therapeutic choices with them, make them feel an active part . Today we have tools and drugs that allow us to broaden the horizons of our therapeutic armamentarium “. Innovation, Leone echoes, “means freeing up resources in a system that does not have unlimited resources”. The doctor-patient relationship is a key to achieving this goal, is the message of the director general of the Amici association. And on this front we need to do more, judging by what emerges from the investigations that have taken place over time. One for example “shows how the patient’s priorities number 1 and number 2 are in seventh and eighth place in the doctor’s list and vice versa: the doctor’s first and second priorities are in eighth and fifth place in the patient’s list . Creating a relationship is necessary, even if it is tiring and demanding “. As for drugs, what is the challenge for the future? “Those who produce drugs must concentrate on a very important aspect: it is not only clinical recovery that counts, but also having drugs that have methods of administration that guarantee a good quality of life”, continues Leone. “Having a drug that works well is an advantage”, he specifies, but it is also an advantage “if it allows the patient not to stay 4 hours in the hospital, if it guarantees a better quality of life and allows those who need it not to be absent from the hospital. work, therefore more productivity. The invitation we are launching to pharmaceutical companies is to invest in this field. Then we must make it clear to those who pay them for drugs that a drug can be more expensive, but if it allows to control the disease it can also be a savings in another expense item “. The logic must also be to give each patient the right treatment, but also in the way that is most tailored to his or her life needs. “I claim the centrality of the doctor who establishes the best treatment and strategy – concludes the Dg of Amici Onlus – but there are areas of comparison. You can say: ‘Doctor, I prefer to come to the hospital to give the infusion’, or ‘I can’t allow myself to be off work and I prefer another way of administering the treatment. “Active involvement of the patient and raising the level of mutual trust is needed, for the good of the patient and for a sustainable health service”.