Retrospective observational study of disparities in biologic therapy access for inflammatory bowel disease in New Zealand (2016–2020); using official information ACT (OIA) data

Equitable access to biologic therapy for inflammatory bowel disease is an issue. All 20 district health boards were approached under the Official Information Act to provide anonymised information on the number of patients with inflammatory bowel disease who were treated with biologics between 2016 and 2020, by ethnicity. Expected numbers were calculated from population and prevalence data. The proportions of patients in various minority communities and the White New Zealand Population were compared using a z statistic. Only seven Health Boards replied and more than 1800 patients were admitted to hospital or a day case unit to initiate therapy with a biologic. The main findings were: no significant overall difference between the observed number of Maori patients who had received biologic therapy compared to expected; no difference in access to biologics in the South Asian community; in Taranaki, which treated the largest number of patients significantly fewer Maori patients were treated than would be expected ( z = −3.07, p < 0.002); and in Counties Manukau, which has a large South Asian population, significantly fewer members of the community with inflammatory bowel disease received biologic therapy than would have been expected ( z = 4.4, p < 0.00001). The implications of these findings are discussed. Inequitable access to biologic therapies means that patients with inflammatory bowel disease will have a poorer quality of life and have a greater need for surgery.