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Disparities in the organisation of national healthcare systems for treatment of patients with psoriatic arthritis and axial spondyloarthritis across Europe
B. Michelsen, M. Østergaard, MJ. Nissen, A. Ciurea, B. Möller, L. Midtbøll Ørnbjerg, P. Horák, B. Glintborg, A. MacDonald, K. Laas, T. Sokka-Isler, B. Gudbjornsson, F. Iannone, P. Hellamand, TK. Kvien, AM. Rodrigues, C. Codreanu, Z. Rotar, I....
Language English Country Ireland
Document type Journal Article, Review
- MeSH
- Antirheumatic Agents * therapeutic use economics MeSH
- Axial Spondyloarthritis * drug therapy MeSH
- Biological Products therapeutic use economics MeSH
- Healthcare Disparities * statistics & numerical data MeSH
- Humans MeSH
- Delivery of Health Care * organization & administration MeSH
- Surveys and Questionnaires MeSH
- Arthritis, Psoriatic * drug therapy MeSH
- Spondylarthritis * drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Studies on national policies for biologics are warranted. OBJECTIVES: To map and compare national healthcare set-ups for prescription, start, switch, tapering, and discontinuation of biologic/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis and axial spondyloarthritis across Europe, and assess the healthcare set-ups in relation to countries' socio-economic status. METHODS: An electronic survey was developed to collect and compare information on national healthcare systems. The relationship between the cumulative score of biologic/targeted synthetic DMARD regulations, socioeconomic indices, and biologic originator costs were assessed by linear regression. RESULTS: National healthcare set-ups differed considerably across the 15 countries, with significantly fewer regulations with increasing socioeconomic status measured by GDP/current health expenditure/human development index, and with increasing biologic originator costs. In most countries, the biologic/targeted synthetic DMARD prescribing doctor was required to adhere to country and/or hospital recommendations, and about a third of countries had a national/regional tender process. Prescription regulations for biologic/targeted synthetic DMARDs, including pre-treatment and disease activity requirements, varied substantially. Approximately a third of countries had criteria for discontinuation and tapering, whereas only few had for switching. Notably, two countries disallowed biologic/targeted synthetic DMARD retrials, and one imposed limit on the maximum number of biologic/targeted synthetic DMARDs permitted. CONCLUSION: The findings highlight substantial variability in healthcare set-ups for biologic/targeted synthetic DMARD use in psoriatic arthritis and axial spondyloarthritis across Europe and their association with socioeconomic status and drug costs. These insights provide a basis for rheumatology societies, policymakers, and stakeholders to evaluate and potentially optimize healthcare policies.
Aberdeen Centre for Arthritis and Musculoskeletal Health University of Aberdeen UK
Amsterdam Rheumatology Immunology Center Reade and Amsterdam UMC Amsterdam Netherlands
Center for Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania
Center for Treatment of Rheumatic and Musculoskeletal Diseases Diakonhjemmet Hospital Oslo Norway
Centre for Rheumatology Research Landspitali University Hospital Reykjavik Iceland
Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden
Department of Clinical Medicine Aarhus University Aarhus Denmark
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Internal Medicine Dermatology and Psychiatry Universidad de La Laguna Spain
Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Rheumatology Aarhus University Hospital Aarhus Denmark
Department of Rheumatology and Immunology Inselspital University Hospital Bern Switzerland
Department of Rheumatology East Tallinn Central Hospital Tallinn Estonia
Department of Rheumatology Geneva University Hospital Geneva Switzerland
Department of Rheumatology Hospital Garcia de Orta Almada Portugal
Department of Rheumatology Hospital General Universitario Gregorio Marañón Madrid Spain
Department of Rheumatology Hospital Universitario de Canarias Universidad de La Laguna Spain
Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland
Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia
EpiDoC unit CHRC Nova Medical School Lisbon Portugal
Faculty of Medicine Complutense University of Madrid Spain
Faculty of Medicine University of Iceland Reykjavik Iceland
Faculty of Medicine University of Ljubljana Ljubljana Slovenia
Institute of Rheumatology Prague Czech Republic
Instituto Medicina Molecular Faculdade de Medicina da Universidade de Lisboa Portugal
National Institute for Health Development Tallinn Estonia
Olomouc University Hospital Olomouc Czech Republic
Radboud University Medical Centre Nijmegen the Netherlands
Research Unit Sørlandet Hospital Kristiansand Norway
Reuma pt Sociedade Portuguesa de Reumatologia Lisbon Portugal
Rheumatology Inflammation Center Helsinki University Hospital Helsinki Finland
Rheumatology Unit DiMePRe J University of Bari Italy
References provided by Crossref.org
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