Nuffield Department of Primary Health Care Sciences, University of Oxford

Academic Institute

OFHS240226

Immune mediated inflammatory diseases include conditions like rheumatoid arthritis, psoriasis and inflammatory bowel disease. These conditions sometimes need treatment with biologic medicines that target specific parts of the immune system. Biologic medicines are medicines that are more expensive than traditional drugs because the manufacturing process uses living cells, is complicated and needs strict quality checks. They are prescribed by specialised doctors in hospital and can make major improvements in people’s health. Our research aims to explore whether biologic medicines are prescribed fairly across different demographic groups in patients with immune mediated inflammatory diseases. We will analyse self-reported data from the Our Future Health (OFH) cohort to address the following questions: 1. How many patients in the OFH cohort self-report to have immune mediated inflammatory diseases? 2. What are the demographics of these patients such as age, gender, ethnicity, education, income, or household characteristics? 3. What is the proportion of these patients on older cheaper medications compared to newer, more expensive biologic medicines? Our objectives are to investigate any treatment inequities in the prescribing of biologic medicines and describe the contributing factors to establish foundations for strategies to improve equitable access. Biologic medicines have become crucial in treating diseases like arthritis and inflammatory bowel disease. These drugs are very effective but also very expensive, which creates challenges in ensuring everyone who needs them can get them. In the UK, there have been issues with unequal access to these treatments, depending on where people live. This problem, often called a "postcode lottery," means some patients might not get the best care because of where they reside. Our study aims to investigate how these medicines are prescribed across different demographic groups, such as ethnicity, education level and socioeconomic factors, to see if there are any unfair patterns. We want to understand what causes these disparities and suggest ways to make the system fairer. By doing this, we aim to help create a healthcare system where treatment decisions are made based on a patient's medical needs rather than their background or location.

Immune mediated inflammatory diseases are prevalent and disabling and can affect up to 7% of the population in the UK. Socioeconomic factors affect how these diseases progress, with lower income linked to worse disease outcomes. This research is expected to provide significant public benefits by highlighting any unequal access to biologic medicines for treating immune mediated inflammatory diseases. By examining self-reported prescription patterns across different demographic groups, our study aims to identify and address any unfairness in who receives these effective, but costly treatments. The insights gained could help healthcare providers and policymakers create a fairer system, where decisions are based on medical need, not NHS funding or local decisions. For example, if our findings show that a specific group is less likely to receive biologic medicines, targeted interventions can be developed to help. Ultimately, this research aims to improve health outcomes and provide better, fairer healthcare for all patients with these challenging chronic diseases.

Public Health Research

26/11/2025

21/02/2025

TRE