Access, Affordability, and Innovation in IBD Care, With Jamie Brogan, NP

The evolving management of inflammatory bowel disease (IBD) continues to bring both opportunities and challenges, particularly around patient access, individualized care, and navigating an expanding therapeutic pipeline. Despite advances in treatment options, most recently with the US Food and Drug Administration (FDA) approvals of guselkumab (Tremfya) and mirikizumab (Omvoh) in Crohn’s disease, barriers such as insurance restrictions, white bagging, and cost continue to create hurdles for patients.

At the 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference, Jamie Brogan, NP, a nurse practitioner at Northwestern Medicine, discussed positioning medications in Crohn’s disease as more treatment options continue to emerge and new hurdles present unprecedented challenges in patient care.

Check out part 1 of the interview here.

“I know we all want to live in a world where my medical opinion is what it is and the patient can get the medicine we think is the most appropriate in a timely fashion and stay on it with no barriers. Unfortunately, that's not the world that we live in,” Brogan told HCPLive, emphasizing the importance of taking patient factors like cost, insurance, and potential needle phobias into consideration.

Looking ahead at potential future innovations in the field, Brogan expresses cautious optimism about what may be next, noting that we cannot be entirely sure about how a medicine is going to be used until it is made available. Specifically, she cites agents that she felt looked promising in clinical trials that “did not end up turning out well” as well as agents coming to market with unexpected FDA approvals, like upadacitinib.

“I'm excited to see what ends up getting approved, but until that happens, we have some really strong options and availability now on the market that we're still working our way through in many of our patients,” Brogan said.

She goes on to explain that although IBD does not have a step-by-step algorithm for treatment like other diseases, this presents opportunities to individualize care and consider unique aspects of each patient.

“There are pros and cons to all of the sequencing conversations, but don't be intimidated by it,” Brogan said.

References

1. Campbell P. FDA Approves Guselkumab (Tremfya) For Crohn Disease. HCPLive. March 20, 2025. Accessed September 16, 2025. https://www.hcplive.com/view/fda-approves-guselkumab-tremfya-for-crohn-disease

2. Brooks A. FDA Approves Mirikizumab (Omvoh) for Crohn’s Disease. HCPLive. January 15, 2025. Accessed September 16, 2025. https://www.hcplive.com/view/fda-approves-mirikizumab-omvoh-for-crohn-disease