Salix survey shows many IBS patients suffer in silence for years before speaking to their physician

Salix Pharmaceuticals has identified a blockage in the irritable bowel syndrome (IBS) care pathway. Based on an online survey of 724 people, the manufacturer of a pair of IBS treatments thinks more than half of people are waiting one year or more before mentioning their symptoms to a healthcare provider.

To understand the experience of patients with IBS with constipation (IBS-C) and and IBS with diarrhea (IBS-D), Salix, which sells Trulance and Xifaxan for use in the indications, asked a set of questions about when and why individuals sought care and what happened after they spoke to a healthcare provider. The findings (PDF) suggest many patients suffer in silence for months and even years.

Salix split the data between individuals with IBS-C, including people with chronic idiopathic constipation (CIC), and respondents with IBS-D. Neither group was quick to contact their healthcare provider. While 16% to 17% of patients spoke to a healthcare provider within six months, a similar proportion of people waited more than five years. Across both groups, around half of respondents waited more than one year. 

Asked why they waited, respondents said they were unaware IBS was a chronic condition, thought they could resolve the symptoms by changing their diets or had tried over-the-counter drugs without success. Worryingly for Salix and rivals such as AbbVie and Ironwood, which sell Linzess for use in IBS-C and CIC, 26% of constipation patients and 21% of people with IBS-D were unaware of prescription treatments that could help. 

Raising awareness of treatment options could help trigger conversations and ultimately sales, although the survey shows encouraging patients to talk to healthcare professionals is only part of the challenge for Salix and its rivals. The drugmakers also need physicians to prescribe their products—and the poll shows many doctors reach for other options when a patient first presents with IBS-C or IBS-D.

Fewer than one-third of patients with either condition were initially recommended a prescription drug. The top two recommendations in IBS-C were to increase water intake and avoid certain foods, while the IBS-D cohort was typically advised to stay away from certain foods and to track their symptoms. Around 40% of patients were prescribed a drug within three months but others waited years.   

Many IBS-C patients will initially receive Linzess, a blockbuster drug that is more strongly recommended by the American Gastroenterological Association than its rivals, but the survey shows only 26% of people experience full symptom relief from the first prescription drug. Salix could generate sales if those people switch to other drugs, but the poll shows only some patients discuss untreated symptoms with doctors. 

Salix, which ran similar surveys in 2021 and 2022, is gathering insights to identify ways to accelerate the growth of two key products. Bausch Health, which owns Salix, cited (PDF) Trulance and Xifaxan as growth drivers last year. Driven by rising sales of the products, Salix revenues grew 4% in the fourth quarter and 1% across all of 2022.