Abstract

Abstract Background The number of patients in Poland diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) has been increasing in the last decade, which implies an increase in the number of severe cases, where biologic treatment is required. The aim of this study was to analyse the usage of biologic treatment among patients with both types of inflammatory bowel diseases (IBD) in Poland that was reimbursed by the National Health Fund (NFZ) in 2020. Methods The analysis was conducted using administrative data collected since the year 2009 by the National Health Fund (NFZ), the only public payer in Poland. We defined an IBD patient receiving biologic treatment as a patient: (1) who had at least two inpatient/outpatient records in the NFZ registry in the years 2009 – 2020 with ICD10 code K50/K51 assigned; (2) who had filled at least two prescriptions for IBD medications two months apart or who had undergone intestinal surgery prior to the record; (3) and who received biological treatment reimbursed by the NFZ in 2020. We assessed the total percentage of patients with each diagnosis who received biologic treatment as well as the percentage by sex, by age group and by the place of residence (voivodeship). Results In 2020, the percentage of patients treated with biologic agents in the population of CD patients was 7.9% (1 863 / 23 574). The percentage of patients treated with biologic agents in the population of UC patients was 1.6% (1 174/73 235). The rate of patients treated with biologics for both CD and UC was significantly lower in women than in men (p<0,001 for both). Among all age groups, the highest percentage of patients receiving biologic treatment for both CD and UC (21,7% and 6,5%, respectively) was observed in those aged 10–19 years and the lowest percentage in patients aged over 70 years (0,8% for CD, 0,2% for UC). The highest proportion of patients treated with biologic drugs among CD patients was found in the Mazovian Voivodeship (13.8%) and the lowest - in the Lubusz Voivodeship (1.2%). In UC, the highest biologic treatment rate was observed in the Świętokrzyskie Voivodeship (3.1%), and the lowest in the Lubusz Voivodeship and the Warmian-Masurian Voivodeship (both 0.2%). Conclusion The use of biologic agents in the treatment of both Crohn’s disease and ulcerative colitis in Poland has been presented. Female patients receive biologic treatment for IBD significantly less frequently than male. The highest proportion of patients receiving biologic treatment for both CD and UC was found in the paediatric population. There are voivodeships in Poland where the access to biological treatment is unacceptably low.

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