Patterns Of Adoption And Diffusion Of Biological Therapies In Inflammatory Bowel Disease: Patient-Centric Insights From Israel
Author(s)
Ruslan Sergienko, BSc, MHA1, Doron Schwartz, MD, MHA2, Ganit Goren, PhD3, Michael Friger, PhD4, Alon Monsonego, PhD5, Orly Sarid, PhD3, Vered Slonim-Nevo, PhD3, Shmuel Odes, PhD6, Dan Greenberg, PhD1.
1Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 2Soroka Medical Center, Beer-Sheva, Israel, 3The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 4Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 5The Shraga Segal Department of Microbiology, Immunology, and Genetics, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 6Division of Internal Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
1Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 2Soroka Medical Center, Beer-Sheva, Israel, 3The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 4Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 5The Shraga Segal Department of Microbiology, Immunology, and Genetics, Ben-Gurion University of the Negev, Beer-Sheva, Israel, 6Division of Internal Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
OBJECTIVES: Inflammatory Bowel Disease (IBD), including Crohn’s Disease (CD) and Ulcerative Colitis (UC), significantly impacts healthcare costs and patient health-related quality of life. The introduction of biological drugs, while transformative in clinical outcomes, presents challenges due to high costs and varied patterns of adoption and diffusion. This study aimed to understand the impact of socio-demographic, disease-related, and treatment-related factors on the adoption and diffusion of biological therapies in IBD patients in Israel, comparing patterns between CD and UC, and between different biologic therapies.
METHODS: We conducted a retrospective cohort analysis of 49,267 IBD patients from 1998 to 2018 across four major health maintenance organizations (HMOs) covering 98% of Israel's population. Data on biological drugs usage, socio-demographic (age, sex, ethnicity, district), and clinical variables were extracted. Time-to-event analysis using Kaplan-Meier and Cox proportional hazards models assessed adoption timelines and associated factors.
RESULTS: Biological drugs adoption was significantly higher among pediatric-onset IBD patients (CD: HR=1.57, 95% CI: 1.48-1.67; UC: HR=1.41, 95% CI: 1.26-1.59). Arab UC patients had a 40% higher adoption rate compared to Jewish patients, an ethnicity-based difference not observed in CD patients. Treatment history significantly influenced adoption, notably steroid (CD: HR=1.72; UC: HR=6.37) and immunosuppressant therapies (CD: HR=3.45; UC: HR=5.81). Diffusion of biological drugs followed an S-curve, notably driven by the initial biologic drug (Infliximab). Adoption and diffusion rates were higher in CD compared to UC patients, influenced by the timing and order of market introduction of biologics.
CONCLUSIONS: Socio-demographic and clinical factors significantly influence the adoption and diffusion of biological drugs in IBD, highlighting a shift towards patient-centric, severity-based approaches. Understanding these factors can inform policy-making and collaboration strategies to enhance patient access and optimize healthcare value. Future research should explore the economic and clinical outcomes associated with varying diffusion patterns.
METHODS: We conducted a retrospective cohort analysis of 49,267 IBD patients from 1998 to 2018 across four major health maintenance organizations (HMOs) covering 98% of Israel's population. Data on biological drugs usage, socio-demographic (age, sex, ethnicity, district), and clinical variables were extracted. Time-to-event analysis using Kaplan-Meier and Cox proportional hazards models assessed adoption timelines and associated factors.
RESULTS: Biological drugs adoption was significantly higher among pediatric-onset IBD patients (CD: HR=1.57, 95% CI: 1.48-1.67; UC: HR=1.41, 95% CI: 1.26-1.59). Arab UC patients had a 40% higher adoption rate compared to Jewish patients, an ethnicity-based difference not observed in CD patients. Treatment history significantly influenced adoption, notably steroid (CD: HR=1.72; UC: HR=6.37) and immunosuppressant therapies (CD: HR=3.45; UC: HR=5.81). Diffusion of biological drugs followed an S-curve, notably driven by the initial biologic drug (Infliximab). Adoption and diffusion rates were higher in CD compared to UC patients, influenced by the timing and order of market introduction of biologics.
CONCLUSIONS: Socio-demographic and clinical factors significantly influence the adoption and diffusion of biological drugs in IBD, highlighting a shift towards patient-centric, severity-based approaches. Understanding these factors can inform policy-making and collaboration strategies to enhance patient access and optimize healthcare value. Future research should explore the economic and clinical outcomes associated with varying diffusion patterns.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD83
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Disease
Biologics & Biosimilars, Gastrointestinal Disorders