What Is Crohn’s Disease?

Crohn's Disease is a form of inflammatory bowel disease (IBD) in which part of the gastrointestinal tract, usually the small intestine and/or colon, is inflamed. In most cases, patches of inflamed bowel alternate with patches of normal, healthy bowel. Serious intestinal complications of Crohn’s disease include bowel obstruction, which is caused by swelling of the intestine leading to the development of scar tissue that narrows the passage. Symptoms of Crohn’s disease include frequent diarrhea, cramps or abdominal pain, fever, loss of appetite, weight loss, fatigue, and occasionally, rectal bleeding. People with this disease experience flare-ups of symptoms, followed by periods of time without symptoms (called a remission). Crohn’s disease varies from one person to the next, based on the location of the bowel inflammation.

The exact cause of Crohn’s disease is not known, but is thought to be due to problems with a person’s immune system. Some researchers believe the condition may be caused by an infection, although no specific organism has yet been identified. People with Crohn’s disease may also have arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, or diseases of the liver.

It is estimated that as many as 650,000 people in the US suffer from Crohn’s disease, most of them diagnosed with Crohn’s disease in their 20s or 30s. The condition often runs in families.

Currently, there is no cure for Crohn’s disease, but there is treatment to control inflammation, correct nutritional deficiencies and relieve symptoms. This treatment includes drugs, nutritional supplements, surgery, lifestyle changes, or any combination of these therapies.

Medicines used to treat Crohn’s disease include:

•Aminosalicylates

•Corticosteroids

•Antibiotics

•Immunomodulators

•Biologic therapies

Aminosalicylates are anti-inflammatory drugs that work in the intestine. They are prescribed for treatment of the disease during flare-ups and also to keep symptoms from returning during a period of remission. Aminosalicylates are available in oral, enema and suppository forms under the names of sulfasalazine, olsalazine, mesalamine, and balsalazide.

Corticosteroids are also used to decrease intestinal inflammation during flare-ups. While these drugs are effective, they can’t be used for long periods of time because they can cause some serious side effects such as bone loss, weight gain, increased blood pressure, and diabetes. Medicines in this class include prednisone, methylpednisolone and budesonide.

People with Crohn’s disease often develop infections because of inflammation and/or blockage in the bowel. When this happens, doctors often prescribe antibiotics such as metronidazole and ciprofloxacin.

In people with more severe forms of Crohn’s disease, drugs that change the function of the immune system may be prescribed. These drugs are called immunomodulators and can be used to prevent symptoms during periods of remission, as well as to cause remission during flare-ups. These medicines include azathioprine and 6-mercaptopurine. Less commonly, cyclosporine A and methotrexate are used.

Infliximab (Remicade^®) is a new biologic therapy that reduces the symptoms of Crohn’s disease, and causes and maintains periods of remission. Unlike other drugs for this condition, Remicade is given via intravenous (IV) infusion. The dose of Remicade varies between individuals and is based on the individual’s weight.

In serious cases of Crohn’s disease where the bowel becomes obstructed, surgery may be required to remove the diseased or blocked area. A person in this condition often has difficulty taking in enough nutrients to maintain health and weight, so nutritional supplements may also be given. Doctors prefer to prescribe oral supplements, but if this doesn’t work, the supplements may be given intravenously.

Caremark understands that people with Crohn’s disease have special needs. We’ll make sure you get your prescribed Remicade^® or other medicines from our Specialty Pharmacy, along with the medically necessary supplies you need to safely and correctly administer your treatment.

Caremark has more than 25 years experience with injectable and infused medicines, working closely with each doctor, clinician and participant to make sure medicines are administered as effectively as possible. In addition to providing your prescribed medicines and supplies, Caremark Specialty Pharmacy Services helps in many other ways:

Education. We’ll provide you with the information and resources to learn all about Crohn’s disease, the medicines, lifestyle issues, ways to manage your disease and treatment, and the importance of following your treatment plan.

Customized Care. Sticking to your treatment plan is a top priority, so Caremark assigns each participant a pharmacist-led CareTeam. Your CareTeam will review your medicine schedule, work with you to resolve any injection-related issues, discuss proper waste disposal, and stress the importance of managing your own therapy. We’ll also coordinate nursing services when requested and approved.

Ongoing Communication. Your CareTeam will call you periodically to answer questions, help with treatment issues, schedule shipments of your medicine, and support you in your treatment plan. We also communicate regularly with the manufacturers of these medicines so we can keep you informed about additional support materials and services.

Discreet Deliveries. We know how important your privacy is, so we’ll ship your medicines in secure, plain, temperature-controlled packaging to your home, office or doctor’s office—at your direction.

24-Hour Availability. We’re here when you need us. Our Specialty Pharmacy pharmacists are available 24 hours a day, 365 days a year, in case of emergencies.

With Caremark, you’ll have a team of experts on your side, helping you get the most professional, caring and cost-effective service. If you would like to find out more about our services, please call CaremarkConnect^® toll-free at 1-800-237-2767.

Navigating Insurance

To inquire about or begin services with Caremark Specialty Pharmacy Services, please call or have your healthcare provider call CaremarkConnect® at 1-800-237-2767. You may also begin the enrollment process here. Once you fill out the requested information, one of our staff of specialists will contact you. Regardless of how you begin the process, our staff of specialists will work with you and your insurance carrier to confirm coverage for your treatment. We’ll conduct a full benefits investigation for you for the medicines you may need.

A specialist will assist you with:

•Securing coverage for your new prescription

•Determining your coverage and minimizing out-of-pocket costs

•Processing insurance paperwork and coordinating benefits

•Handling prior authorization issues

•Obtaining all necessary authorizations

•Communicating your financial obligations verbally and in writing

•Assisting in the coordination of home administration services

•Arranging delivery of your medicines

•Coordinating the start of therapy with your doctor

To explore financial coverage alternatives when insurance is not available to you, we offer Caremark Customer Assistance at 1-800-331-7171. Our staff of specialists will work with you to explore coverage alternatives when insurance is not an option. Please feel free to call us with questions or problems.

To inquire about or begin services with Caremark Specialty Pharmacy Services, please call or have your healthcare provider call CaremarkConnect® at 1-800-237-2767. You may also begin the enrollment process here . Once you fill out the requested information, one of our staff of specialists will contact you. Regardless of how you begin the process, our staff of specialists will work with you and your insurance carrier to confirm coverage for your treatment. We'll conduct a full benefits investigation for you for the medicines you may need.

You may find these Web sites/organizations helpful*:

National Digestive Diseases Information Clearing House

Crohn’s and Colitis Foundation of America

* Caremark does not operate the Web sites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by Caremark. Information from these Web sites/organizations is not a substitute for medical advice or treatment. Discuss any information you find with your doctor or healthcare professional.

References

Copyright © 2005 Consumer Health Interactive

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