A win for IBD patients – subsidisation of faecal calprotectin and new developments
Inflammatory bowel disease (IBD) is a chronic inflammatory condition that affects the gastrointestinal tract. Diagnosis typically involves a colonoscopy, which allows direct visualization of the gut wall using a camera. Tissue samples can also be taken for microscopic examination. While colonoscopies are relatively straightforward and low risk, they are still invasive and require preparation as well as sedation, which carries associated risks. Additionally, the procedure can take time away from work and needs transportation to and from the hospital.
Faecal calprotectin (FC) is a commonly used non-invasive test for aiding the diagnosis and monitoring of IBD. It measures inflammation in the gastrointestinal tract through a stool sample. When combined with blood tests and a patient’s symptoms, it helps doctors determine whether a patient is in remission or experiencing a disease flare. The process involves dropping off an early morning stool sample at a lab and waiting 1–2 weeks for results. Additionally, the test comes with significant out-of-pocket costs, reaching up to $90. These financial and logistical barriers have been shown to decrease patient compliance compared to blood tests.
In 2024, a new submission to the Medical Services Advisory Committee (MSAC), a government-run organisation that determines which health services or technologies should be publicly funded, was partially accepted regarding the subsidisation of faecal calprotectin (FC) testing. The submission was led by the Gastroenterological Society of Australia, with involvement from Crohn’s and Colitis Australia (CCA). The proposed subsidisation would apply to FC testing used for monitoring inflammatory bowel disease (IBD), potentially saving patients who require multiple tests each year hundreds of dollars. MSAC acknowledged input from IBD patients and organisations like CCA, noting that patients preferred to avoid colonoscopy due to its invasiveness, disruption to daily life (including school and work), potential need for overnight hospitalization, and high out-of-pocket costs.
Once the subsidisation of faecal calprotectin (FC) testing is rolled out, a significant financial barrier affecting compliance will likely be eliminated. Laboratory testing is not the only way to monitor FC levels; home-based FC testing kits and point-of-care tests are available in other countries and provide fairly accurate results in less than an hour. Like a COVID rapid antigen test (RAT), stool samples are mixed with a buffer solution and placed in a device that displays two lines: one for control and one indicating an elevated FC level. A smartphone can then be used to estimate the FC level based on the intensity of the coloured line. Wins like this would not have been possible without the dedicated work of GESA, CCA, and the many IBD patients who contributed their voices.
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