Personalizing Therapy for Inflammatory Bowel Diseases
Advances in therapy have significantly improved our ability to care for patients with IBD. In addition, recent trials have challenged our conventional management paradigms and suggested alternate and top-down approaches to therapy with focus on prevention of cumulative accrual of bowel damage, preservation of bowel function and maintenance of optimal health-related quality of life. However, there is also increasing focus on being able to deliver cost effective care on a societal scale. Many of the existent potent therapies are several magnitudes more expensive than conventional immunomodulating agents, and with availability of newer drugs, are unlikely to become substantially less expensive. Thus, from a societal standpoint, we are going to be increasingly charged with delivering care that is not only effective but also cost effective on a societal scale recognizing both direct and indirect costs of disease. In addition, patient concerns regarding long-term safety of such therapies remain given need for continued ongoing treatment over decades of life. Thus, it is going to be imperative for us to be able to tailor therapy to individual patients in an attempt to deliver both personalized and precision care that maximizes benefits and minimizes risks while remaining cost effective.
Five-Year View
Advances in therapy have significantly improved our ability to care for patients with IBD. In addition, recent trials have challenged our conventional management paradigms and suggested alternate and top-down approaches to therapy with focus on prevention of cumulative accrual of bowel damage, preservation of bowel function and maintenance of optimal health-related quality of life. However, there is also increasing focus on being able to deliver cost effective care on a societal scale. Many of the existent potent therapies are several magnitudes more expensive than conventional immunomodulating agents, and with availability of newer drugs, are unlikely to become substantially less expensive. Thus, from a societal standpoint, we are going to be increasingly charged with delivering care that is not only effective but also cost effective on a societal scale recognizing both direct and indirect costs of disease. In addition, patient concerns regarding long-term safety of such therapies remain given need for continued ongoing treatment over decades of life. Thus, it is going to be imperative for us to be able to tailor therapy to individual patients in an attempt to deliver both personalized and precision care that maximizes benefits and minimizes risks while remaining cost effective.
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