Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 19;21(5):647.
doi: 10.3390/ijerph21050647.

Improving Accessibility to Patients with Interstitial Lung Disease (ILD): Barriers to Early Diagnosis and Timely Treatment in Latin America

Ricardo G Figueiredo  1 , Nathalia Filgueiras Vilaça Duarte  2 , Daniela Carla Barbosa Campos  2 , Manuel de Jesus Diaz Verduzco  3 , Ángel Alemán Márquez  4 , Gabriela Tannus Branco de Araujo  5 , Adalberto Sperb Rubin  6
Affiliations

Improving Accessibility to Patients with Interstitial Lung Disease (ILD): Barriers to Early Diagnosis and Timely Treatment in Latin America

Ricardo G Figueiredo et al. Int J Environ Res Public Health. .

Abstract

Delayed initiation of effective antifibrotic therapy in patients with interstitial lung diseases (ILD) may influence the progression and outcome of the disease. This study analyzes the differences in the journey of patients with ILD in the Brazilian and Mexican health systems. An evaluative study was conducted in reference centers for interstitial lung diseases in Brazil and Mexico with a panel of four specialists. The patient's journey in both countries begins when the patient seeks medical care after observing a chronic respiratory symptom. In both countries, due to diagnostic complexity, these patients arrive at ILD referral centers at an advanced stage of the disease. Once diagnosis is established, the treatment onset differs between Mexico and Brazil. In Brazil, access to antifibrotic drugs through the public health system has been a significant challenge, and their cost makes them unaffordable for most people. This situation forces medical specialists to provide only supportive care to patients until these drugs can be accessed. In Mexico, antifibrotics have been available in health sectors since 2018. Brazil and Mexico have several similarities regarding the initial journey of the patient due to diagnosis difficulties. Still, the outcome tends to be different due to a difference in access to treatment with antifibrotics. For this reason, advancing health policies that ensure proper treatment for patients with ILD is crucial for the sustainability and reliability of the health system.

Keywords: Latin America; interstitial lung diseases; patient journey.

PubMed Disclaimer

Conflict of interest statement

Nathalia Filgueiras Vilaça Duarte is employed by Boehringer Ingelheim International GmbH, and Daniela Carla Barbosa Campos works for Boehringer Ingelheim do Brasil Química e Farmacêutica. Ricardo G. Figueiredo received consulting fees from AstraZeneca and has received honoraria for lectures by AstraZeneca, Boehringer Ingelheim, Chiesi, and GSK. He has also received support for attending the ATS and ERS Conferences. Manuel de Jesus Diaz Verduzco has received honoraria from Boehringer Ingelheim and AstraZeneca and serves on advisory boards and steering committees related to pulmonary fibrosis for Boehringer Ingelheim. He has also been supported in attending the ATS, ERS, and CHEST Conferences. Gabriela Tannus Branco de Araujo is a pharmaceutical and medical device company consultant. Adalberto Sperb Rubin has received grants for lectures and clinical trials from Boehringer Ingelheim do Brasil. Ángel Alemán Márquez declares no conflicts of interest.

Figures

Figure 1
Figure 1
Organization of the Brazilian health system. Adapted from: Health Systems in Transition Vol. 22 No. 2 2020 [23].
Figure 2
Figure 2
Organization of the Mexican health system. IMSS—Mexican Institute of Social Security, ISSSTE—Institute of Social Security and Services for State Employees, PMEX—Mexican Petroleum, MoH—Ministry of Health. Adapted from: Health Systems in Transition Vol. 22 No. 2 2020 [23].
Figure 3
Figure 3
Figure 1 schematically shows the patient’s journey in treating ILD as reported by expert panel.
See this image and copyright information in PMC

References

    1. Mikolasch T.A., Garthwaite H.S., Porter J.C. Update in diagnosis and management of interstitial lung disease. Clin. Med. 2017;17:146–153. doi: 10.7861/clinmedicine.17-2-146. - DOI - PMC - PubMed
    1. Sociedade Brasileira de Pneumologia e Tisiologia Diretrizes de Doenças Pulmonares Intersticiais da Sociedade Brasileira de Pneumologia e Tisiologia. J. Bras. Pneumol. 2012;38((Suppl. S2)):S1–S133.
    1. Verma S., Slutsky A.S. Idiopathic Pulmonary Fibrosis—New Insights. N. Engl. J. Med. 2007;356:1370–1372. doi: 10.1056/NEJMcibr070490. - DOI - PubMed
    1. Harari S., Caminati A. IPF: New insight on pathogenesis and treatment. Allergy. 2010;65:537–553. doi: 10.1111/j.1398-9995.2009.02305.x. - DOI - PubMed
    1. Mueller-Mang C., Ringl H., Herold C. Interstitial Lung Diseases. In: Nikolaou K., Bamberg F., Laghi A., Rubin G.D., editors. Multislice CT. Springer International Publishing; Berlin/Heidelberg, Germany: 2017. pp. 261–288. Medical Radiology. - DOI