Managing Inflammatory Bowel Disease: What to Do when the Best is Unaffordable?

The Lancet Gastroenterology & Hepatology Commission on the cost of inflammatory bowel disease (IBD) in high-income settings1 provides an extensive review of the direct and indirect costs involved in the management of IBD in high-income countries. The Commission describes the interplay of four major factors—disease burden, treatment of the disease and its complications, access to medical care, and the indirect effect of the disease on patients' ability to contribute economically.