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Receiving biologic drugs overseas

 

 

 

Moving or travelling abroad for extended periods If you are taking biologic medications (e.g. Infliximab, adalimumab, Vedolizumab, Ustekinumab) can seem daunting, especially if you have to attend the hospital for an intravenous infision. Forward planning is essential to ensure there is no disruption in your treatment. It is imporant to consider the following:

  • Duration of your trip - Long trips with multiple destinations may be more difficult to coordinate, particularly with medications such as biologics that often require funding before treatment can be started.
  • Avaialbility of medication- Not all medications are available in every country or they may be called a different name. 
  • Access to healthcare- What is the healthcare system at your destination? Will you have to self-pay or will your exising medical insurance cover you? If you are working/ studying overseas will your visa cover healthcare? Does your country have reciprocal healthcare agreements with the destination country? 

Learn more about IBD and travel

Obtaining health care abroad

For emergency medical care abroad, see our IBD Network page which can help you in finding an IBD center with an emergency room and facilities such as radiology and operating rooms to address possible emergencies

For receiving scheduled consult, and specifically to schedule an infusion of a biologic drug that you regularly receive (e.g. Remicade, Entyvio, Remsima, Inflectra), you will need to contact the medical center or the infusion center in the destination country beforehand to enquire:

  1. Can the center infuse you with medication vials that you brought over from your country? Regulations about infusions of drug vials brought independently by patients vary among countries. Moreover, some biologic drugs may be approved already for use in one country but not yet approved at the destination country, precluding its administration even if you bring it with you, or requiring special procedures to allow for this. 
  2. Do you need to see a local IBD doctor before the infusion ? In most countries an infusion center will not infuse the drug to you without a medical order by a local medical (IBD) doctor. Usually, but not always, this doctor will be located at the center where the infusion center.
  3. Can you obtain the drug at the center or at a pharmacy (if you have not brought the vials with you) ? This will usually require a prescription from a local doctor as well as purchasing the drug, whether through your insurance plan or paid out of pocket.

 

Top Tips on how to arrange medical treatment overseas

If you are planning to travel or move abroad for an extended period you may find the following tips helpful to facilitate easy transition of your medical care:

  • Plan ahead! Allow at least 8-10 weeks prior to departure to get everything in place ready for your trip. Arranging medical treatment abroad can be done depending on the destination of travel but does take time to arrange.
  • Ask your IBD team to obtain the name and contact details of a Gastroenterologist at the travel destination. This can be done either via the IBD Network page or sometimes, in the case of receiving biologics abroad, the local representative of the company manufacturing the drug can help to locate and contact a doctor and an infusion center at the destination. One such tool for finding biologics infusion clinics in the U.S.A is www.2infuse.com , which is a programme run by Janssen. Other companies may have similar programmes.
  • It is usually necessary for your current IBD team to send a letter of referral outlining your medical history and medications to the Gastroenterologist at the travel destination. This is to ensure they have all the necessary information and to avoid treatment delay, whilst also ensuring you have approval for bringing all medications into the destination country. Please note that some countries may also require additional special permission for controlled drugs such as Codeine. More information on this can be found on the travelling with medication page.
  • Always carry a copy of your most recent clinic letter outlining your medical history, recent investigations and medications . This can be either in paper form or you can download the My Wellness Journal App, which allows you to securely carry your medical records on your mobile device.
  • Once you arrive at the travel destination you will usually have to either register with the local healthcare system or with a private medical insurance company, depending on local arrangements and the reason for your visit (i.e Travel for business may be covered by private medical insurance.) After this has been done you can then arrange an initial appointment with the IBD team to whom all the correspondence has been sent.
  • In the case of biologics, the IBD team at your travel destination may have to apply for funding according to their local guidelines before treatment can commence. Regular travel insurance policies will not cover treatment with biologics, even if your insurance covers pre-existing illness such as Crohn’s or Colitis.

 

Learn more about travelling with Crohn’s Disease. Learn more abut flying with IBD and the effect of high altitudes.

 

Can I have blood monitoring for drugs like azathioprine or methotrexate whilst abroad?

Travel insurance policies will not usually cover routine care such a blood tests and will generally only cover any emergency medical treatment you may require. You must always ensure that you tell the travel insurance company about your IBD BEFORE you travel.

If you are travelling for a long period of time and will require blood monitoring for medication you are taking, this may have to be done in a private medical facility and will incur personal cost to you. Most hotels or travel representatives in the country you are visiting should be able to tell you where the nearest medical facility is. Discuss this prior to travel with your IBD team.

What if my itinerary involves travel to various different locations?

This can often prove more difficult. Depending on the length of time at each destination, the above information may still be applicable. If the duration at each destination is short, or if you plan to move around a lot within a particular country, then arranging continuation of medical treatment abroad may not be possible. Unfortunately there is sometimes no easy answer to the issues raised above and you may have to consider altering your itinerary to something more suitable for your situation.

Alternatively you can look at our interactive map for country specific information and details of IBD centres. Learn more about IBD and travel insurance

Stay informed about coronavirus and how it could affect your travel plans.

Source of information:

  1. National health Service Choices website. Healthcare abroad
  2. Crohn’s and Colitis UK. Travel and IBD information sheet https://www.crohnsandcolitis.org.uk
  3. The colostomy association website http://www.colostomyassociation.org.uk
  4. The ileostomy and internal pouch organisation http://www.iasupport.org/
  5. Crohn’s and Colitis UK. Insurance and IBD information sheet https://www.crohnsandcolitis.org.uk
  6. National health Service Choices website. Healthcare abroad