The biggest obstacles the gastroenterology industry faces

Shrujal Baxi, MD, chief medical officer at Iterative Health, connected with Becker's Dec. 20 to discuss the biggest obstacles the gastroenterology industry faces today on a patient, provider and pharmaceutical level.

Editor's note: This response was edited lightly for clarity and brevity.

Question: What is the biggest obstacle the GI industry faces today?

Dr. Baxi: There are struggles at every level in the GI industry: patients, providers, and pharmaceutical companies all face interconnected challenges to receiving and/or delivering the highest quality of care.

For patients living with inflammatory bowel disease, the cost of treatment continues to rise and there's an urgent need for cost-effective therapies and strategies to alleviate stress placed on patients and their families, especially in tumultuous economic times like these. The price of small bowel medications and biologics is incredibly high and, unfortunately, copayments and reimbursements for preventative care procedures like colonoscopies and endoscopies are low, posing a barrier for many individuals.  

At the provider level, there is a consistent challenge to understand a patient's holistic profile in order to identify the best treatments and therapies. Because of the way our health system works, physicians often see patients for one snapshot of time, which inhibits their understanding of a patient's profile. In tandem, because treatment is so often determined by payer protocols, physicians struggle to connect patients with the strongest, most effective treatment to manage their symptoms and improve their outcomes. Furthermore, we're struggling with specialist shortages — this can be detrimental because so much of preventive care relies on a provider's skills. Take a routine colonoscopy, for example — endoscopists today may miss up to 26 percent of adenomas during colonoscopy — and a physician's reading can be greatly influenced by the volume of patients a provider is seeing, the time of day and general burnout.

Lastly, pharmaceutical companies are challenged by low enrollment and completion rates of clinical trials for inflammatory bowel disease. Qualifying patients for clinical trials can be challenging and we're seeing sites lose patients because of high screen failure rates, which delays clinical trials and inevitably delays patients getting access to more effective therapies. Specifically at Iterative Health, we're seeking to standardize disease severity scoring with artificial intelligence in order to get more treatments in the hands of patients more quickly.

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