P0783Differences in the prescription of advanced therapies for patients with Crohn’s disease and ulcerative colitis in the Brazilian public health system (SUS) versus the Private Health system (PS) in a Brazilian state. “Portrait of a Country with Two Realities”

Abstract Background The Brazilian healthcare system is divided into public (SUS) and Private Health System (PS), both with peculiarities regarding access to therapies for Inflammatory Bowel Diseases (IBD). We aimed to analyze the differences in prescriptions for advanced therapies in patients with Crohn’s Disease (CD) or Ulcerative Colitis (UC) treated in the SUS or PS by the same group of physicians Methods An observational, cross-sectional, and descriptive study. To standardize the sample, data from the same prescribing physicians working in both systems were analyzed. Data were collected from 357 IBD patients undergoing advanced therapies, 230 with CD and 127 with UC, 197 from the SUS and 160 from the PS. Statistical analyses were based on the different access scenarios Results The average income of patients followed by the SUS (Public Health System) was R 1, 527. 39 (US 286. 63), while that of the PS (Private Health System) was R 9, 352. 00 (US 1, 754. 99) ; the rate of education among patients with completed higher education in the SUS was 19. 6%, while in the PS it was 79. 31%, thus highlighting a significant socioeconomic difference between the two patient profiles. In Crohn’s disease (CD), anti-TNF drugs predominated in the SUS (Brazilian Public Health System) N = 95 (81. 9%) vs. the PS (Private Health System) N = 59 (51. 8%) (p 0. 05). Non-anti-TNF drugs predominated in the PS N = 55 (48. 2%) vs. the SUS N = 21 (18. 1%) (p 0. 05). Ustekinumab predominated in the PS N = 45 (39. 5%) while infliximab predominated in the SUS N = 44 (37. 9%). In ulcerative colitis (UC), vedolizumab prescription predominated in the SUS N = 49 (53. 8%) and PS N = 20 (43. 4%) (p 0. 05). Infliximab predominated in the SUS N = 25 (27. 5%) vs. PS N = 07 (15. 2%) (p 0. 05). Ustekinumab N = 9 (19. 5%) (p 0. 05) and Golimumab N = 8 (17. 3%) (p 0. 05) were only prescribed in the PS. Tofacitinib predominated in the SUS n = 17 (18. 6%) vs PS n = 2 (4%) (p 0. 05). Conclusion We observed a significant difference in education and income between IBD patients assisted in the public system versus the private system. The difference in prescriptions between the SUS (Brazilian Public Health System) and the PS (Private Health System) occurred mainly with molecules not included in the Ministry’s protocol or the ANS (National Supplementary Health Agency) list, suggesting that “access” can directly impact prescriptions for IBD patients. Conflict of interest: Prof. Freire, Caio: No conflict of interest Girao, Milena: No conflict of interest Souza, Arthur: No conflict of interest Rolim, Mariana: No conflict of interest Neves Jacinto, Camilla: No conflict of interest Fortes Portela Ferreira, Lucas: No conflict of interest Mendes de Abreu, Carla: No conflict of interest Alves Barbosa, Orivaldo: No conflict of interest José da Silva Neto, Antônio: No conflict of interest Tomaz Pinheiro, Mariana: No conflict of interest Alexsandra Colantonio Dourado, Georgia: No conflict of interest Ivia Ponte Viana, Yuana: No conflict of interest Lemos Carvalho, Pedro: No conflict of interest de Vasconcelos Freire, Laryssa: No conflict of interest