Specialty Pharmacists Reduce Treatment Interruptions in Inflammatory Bowel Disease | ASHP Midyear 2025

In inflammatory bowel disease (IBD), the stakes of every treatment decision are high. Patients live with a chronic, often unpredictable condition that can upend daily life—missing work or school and coping with pain, fatigue, and anxiety about the next flare. Over the past decade, biologic therapies have transformed the IBD landscape, helping many patients achieve remission and reclaim a sense of normalcy. But as patents on these biologics expire, biosimilars—highly similar, more affordable versions—are rapidly reshaping treatment pathways, formularies, and conversations at the clinic level.

That shift brings both opportunity and uncertainty. While biosimilars promise to ease the financial burden on patients and health systems, they also raise complex questions about trust, safety, and what happens when stable patients are switched from a reference product to a biosimilar. For many patients, the idea of changing a therapy that’s finally working can be unsettling. Misinformation, limited understanding of biosimilars, and inconsistent insurance policies only add to the confusion.

In this environment, pharmacists are emerging as critical leaders in patient education and care coordination. Embedded in specialty pharmacies, infusion centers, and gastrointestinal (GI) clinics, they sit at the intersection of clinical decision-making, medication management, and real-world access challenges. They not only help patients understand how their therapies work and what to expect but also monitor efficacy and safety, manage adverse effects, and navigate the maze of prior authorizations, step edits, and financial assistance programs.

Shubha Bhat, PharmD, MS, clinical pharmacist of gastroenterology at Cleveland Clinic, discusses her work within an IBD care team and her research on different education strategies to build patient confidence in biosimilars.

"Evaluating the different education modalities, including the shared medical appointment, the one-on-one pharmacist visit, and the standard pamphlet, to see which method best improves patient confidence with biosimilars," Bhat said. "We found that building patient trust and confidence is crucial. It's not only important to improve uptake, but it's also important to help minimize treatment interruptions and reduce the risk of placebo effect."

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