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ORIGINAL ARTICLE pISSN 1598-9100 • eISSN 2288-1956
http://dx.doi.org/10.5217/ir.2016.14.3.218 Intest Res 2016;14(3):218-223
Differences in the public medical insurance systems for inflammatory bowel disease treatment in Asian countries Shu Chen Wei Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
Background/Aims: The cost of caring for patients with inflammatory bowel disease (IBD) is high. Without government support, the cost burden will unavoidably rest on the patients and their family. However, the government providing full support will place a large financial burden on the health-care systems of a country. The aim of this study is to understand the current status of public medical insurance systems in caring for IBD patients among Asian countries. Methods: Questionnaires inquiring about the availability of public health systems; medical, diagnostic, and endoscopy costs; and coverage rate of biologics use were designed and sent to IBD experts in each of the Asian countries studied. The results were summarized according to the feedback from the responders. Results: The public health insurance coverage rate is high in Taiwan, Japan, South Korea, China, Hong Kong, and Singapore; but low in Malaysia and India. This probably affected the use of expensive medications mostly, such as biologics, as we found that the percentage of Crohn’s disease (CD) treated with biologics were as high as 30%–40% in Japan, where the government covers all expenses for IBD patients. In India, the percentage maybe as low as 1% for CD patients, most of whom need to pay for the biologics themselves. Conclusions: There were differences in the public health insurance systems among the Asian countries studied. This reportprovidesthe background information to understand the differences in the treatment of IBD patients among Asian countries. (Intest Res 2016;14:218-223) Key Words: Inflammatory bowel diseases; Public health insurance; Asian; Diagnosis; Treatment
INTRODUCTION Inflammatory bowel diseases (IBDs) are chronic disabling gastrointestinal disorders affecting every aspect of the affected person’s life, and account for substantial costs to the health-care system and society.1 With the growing number of patients with IBD and cases of hospitalization, the overall medical care cost consequently increases considerably. The annual hospitalization cost per patient, cost per hospitalization, and daily cost during hospitalization have increased significantly in the past decade (all P 90%
1. General Information
Taiwan
We collected responses from Japan (Dr. Tadakazu Hisamatzu), South Korea (Dr. Hyun-Soo Kim), China (Dr. Bayasi Guleng), Hong Kong (Dr. Siew C. Ng), Singapore (Dr. Khoon Lin Ling), Malaysia (Dr. Ida Hilmi), and India (Dr. Vineet Ahuja) in June 2014. The responses were combined with the results from Taiwan, and summarized as the overall results for this report.
Variable
RESULTS
Table 1. General Information of the Public Health Insurance in Asia
Questionnaires were designed to gather (i) general, (ii) diagnosis, (iii) treatment, (iv) disease monitoring, and (v) management information, as well as to inquire about the availability of public health systems, the costs of medical, diagnostic, and endoscopy expense, and the coverage rate of biologics use. The questionnaires were sent to IBD experts in each of the Asian countries studied. The results were summarized according to feedback from the responders. The summarized results were returned for review and approval by the responding IBD experts from each country.
South Korea China
METHODS
Public health 99% insurance cover rate
Hong Kong
Singapore
Malaysia
India
both CD and UC patients.6 There is an apparent shift in cost profile from surgery and hospitalization toward anti-TNF treatment; however, the relatively consistent overall costs suggest that the high costs of these drugs are partly compensated for by a reduction in surgery and hospitalization rates. Without government support, the cost burden of caring for IBD patients will unavoidably rest on the patients and their family. However, if the government will provide full support, it will place a large financial burden on the health-care systems of the country. With the increasing incidence and prevalence of IBD, as well as the use of more and more biologics and state-of-the-art techniques in treating or monitoring IBD patients, how and to what extent public medical insurance support affects current IBD management becomes a practical issue. In this report, we compare the differences in public medical insurance systems for IBD patients among Asian countries, and try to build a basis for understanding the differences and limitations in treating IBD patients among different countries.
