People with inflammatory bowel disease (IBD) often experience substantial barriers to care, leading to critical compromises such as rationing or skipping medications, according to the results of a study recently presented at the Crohn’s and Colitis Congress 2025 in San Francisco.

As MedCentral reports, a 2017 survey identified significant barriers to health care access in patients with inflammatory bowel disease. So, this study examined whether access has improved, focusing on socioeconomic factors, in addition to patient awareness in overcoming these barriers.

By focusing on the experiences of both patients and caregivers, Susan Kais, MD, said this study sheds light on systemic issues within the health care system.

“Understanding these barriers is crucial for developing targeted interventions and advocating for policy reforms to improve access to care and ensure that patients receive the necessary treatment in a timely manner," said Kais, a board-certified gastroenterologist, IBD researcher and assistant professor at the University of Cincinnati College of Medicine. She was not involved in the study.

The study found people with IBD experienced various medication-related challenges, including clerical errors; inability to receive infusions at preferred location; accommodations required to receive medication supplies at home; concerns about side effects; and seeking a second opinion for assistance with appeal denials.

Kais said while prior authorization mandates physicians obtain approval from insurance companies before prescribing certain medications, step therapy requires patients to try insurer-preferred alternatives before receiving the physician-recommended treatment.

“Overall, both prior authorization and step therapy create significant obstacles in IBD management, leading to compromised treatment adherence, increased frustration among patients and, ultimately, poorer health outcomes,” she said.

Among those who experienced medication delays, 69.4% had adverse health outcomes, and 48.7% reported negative effects on daily life and activities.

“The clinical consequences of patients delaying, skipping or rationing their medications due to cost or insurance barriers can be significant and can adversely affect both physical health and overall well-being," said Kaid. "These include disease progression, increased hospitalizations, reduced quality of life, psychological impact and increased health care costs.”

Kais recommends five ways that physicians, policymakers and advocacy groups can make an impact to improve medication access and ensure timely, effective treatment for people with IBD.