On 19 April we celebrated the international day of l to inflammatory bowel disease, a context charged interest to the imminent entry of Ulcerative Colitis to the system of financial protection for Diagnostics and treatments of high cost. The Chilean grouping of labour in Crohn’s disease and Ulcerative Colitis of Chile (ACTECCU), a subsidiary of the Chilean society of Gastroenterology (SChGE), defends the full coverage of the diagnosis and treatment of this costly disease affecting more and more and more young Chileans in the productive period of their lives.
While in Chile there are no rows that allow to say with certainty how many patients there are with Ulcerative Colitis, a clear increase in the incidence and prevalence of this disease and Crohn’s disease diagnosis is evident.
According to Jaime Lubascher, President of ACTECCU, «this phenomenon is not new and is repeated in many countries reached or they are evolving to greater social and economic development as in the case of Chile. Incidence (new cases) in the United States and Europe are rising and fluctuating between 4 to 18 cases per 100,000 inhabitants. There is clear consensus that the situation in Chile move fast towards those numbers.»
Ulcerative colitis is a chronic inflammatory disease that affects the colon in different extent and gravity. It especially affects young people between 20 and 40 years, but also to children and seniors. Treatments are very expensive and difficult to access both in the public and private system. In this regard, Dr. Lubascher says that «a proportion of patients with ulcerative colitis can evolve so severe and refractory to standard therapies and must undergo a surgery that removed them in a complete and definitive the colon and rectum».
As an alternative to this complex surgery are in use worldwide, more than 15 years ago, a group of drugs used injectable Anti – TNF, also known as biologic therapy. These are antibodies monoclonal fabricated to selectively block the tumor necrosis factor alpha, that patients with ulcerative colitis have high and particularly severe cases. «That is why we have fought hand with patients to access them to these expensive therapies under the law Ricarte Soto», says the representative of ACTECCU.
Process to enter into force
The law Ricarte Soto in his Decree 4, finally included therapy with Infliximab, Adalimumab and Golimumab for patients with Colitis serious ulceorosa refractory or inmunorefractarias, but not for all cases. This law would enter into force in July of 2019, so the Ministry of health is already working on the rules and platform to apply to the beneficiary patients.
Dr. Lubascher explains that medical gastroenterologists members of ACTECCU already has experience in this type of process, since a similar one lived 2 years ago with the approval of biologic therapy for Crohn’s disease. «Every patient treated by a specialist in Gastroenterology with diagnosis of ulcerative colitis that complies with the explicit requirements in the regulations under the law (inclusion and exclusion criteria), may file with the Committee of experts appointed by the» Minsal for approval or not,»he added.
The specialist ensures that the law Ricarte Soto only pays for the drug’s high cost, included in the law, but does not solve or pays the rest of the diagnostic or therapeutic process that is still in charge of the patient and their forecast, Fonasa, isapres or forces Armed. «This situation motivates us as physicians to continue fighting to achieve that all the basket tests, diagnostic procedures, vaccines, first and second-line drugs is covered by health systems. Neither Ulcerative Colitis nor Crohn’s are GES pathologies. Our patients require further treatment multidiscilinario with support and intervention of nurses, surgeons, pathologists, psychologists, nutritionists, colorectal, rheumatologists, infectiologists and ginecobstetras, among others», concluded Dr. Jaime Lubascher.