A comprehensive review conducted by Queiroz et al. in 2023 [1] explores the barriers to accessing IBD care throughout Latin America, a large and diverse region used to describe South America, Central America, Mexico and the islands of the Caribbean. Each one of these regions/countries carries a different cultural and historical background, diverse political systems and a distinct healthcare system.
The authors compiled data from multiple sources, including studies on epidemiology, biological penetration and surgical rates. The current number of IBD patients in the region is likely underestimated due to heterogenous epidemiological data and a scarcity of high-quality studies. Therefore, more epidemiological research in the region is warranted.
Biological penetration in Latin America varies significantly between countries in the region. The main reason for this variation is the local implications of heterogeneity within healthcare systems. With regard to surgical rates, scarce and granular data suggest a trend toward reducing surgery over time in Latin America.
Additionally, the authors evaluated overall access to IBD treatments and approvals through a 6-item questionnaire designed to capture perceptions of Latin American physicians. Responses were obtained from 25 out of 47 countries. Most of the non-respondents (18 out of 22) were territories from the Caribbean region. The results have shown that anti-TNFs are currently available in most countries, with at least one non-anti-TNF advanced treatment is available, except in Cuba, Bolivia, Venezuela and Paraguay.
The perception of overall access to therapies was divided in the following classification categories: ‘very difficult’, ‘somehow difficult’, ‘easy’, and ‘very easy/no limitations’. Most of the respondents classified access to IBD treatment as either ‘very difficult’ or ‘somehow difficult’. Notably, only physicians in Aruba evaluated their country as having ‘very easy’ access to medications, while respondents from Brazil, Colombia and Bermuda ranked access to medications as ‘easy’.
The authors found that treatment practices are still very different in general, without local expert guidelines for IBD management. This may reflect substantial inequalities in access to biologicals in Latin America. Despite observed limitations in healthcare systems in Latin American countries, IBD-related care seems to be improving over the last decades. The authors emphasize the need for combined research across the countries to better position the specific challenges in IBD care at an international level.
Conflict of interest
The authors of the research paper [1] declared that there was no conflict of interest.
Abstracted by Camilla de Almeida Martins, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
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First biosimilar of infliximab approved in Brazil: response from the Brazilian IBD society
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Reference
1. Queiroz NSF, Martins CA, Quaresma AB, Olivera Sendra PA, Ernest-Suarez K, Kotze PG. IBD barriers across the continents: a continent-specific analysis: Latin America. Therap Adv Gastroenterol. 2023 Apr 25;16:17562848231167953. doi: 10.1177/17562848231167953. PMID: 37124371; PMCID: PMC10134129.
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