BACKGROUND: The study compared access to disease-modifying treatments (DMTs), care, and services for multiple sclerosis (MS) patients across six Central and Eastern European Countries (CEECs). RESEARCH DESIGN AND METHODS: A 2-part questionnaire-based survey was conducted among experts from Bulgaria, Estonia, Poland, Romania, Serbia, and Slovakia over 4 months (1 December 2022 - 1 April 2023). RESULTS: The study reveals notable variations in the legal requirements for pricing and reimbursement of MS medications, as well as criteria for health technology assessment (HTA) across countries. Despite these differences, DMTs were fully reimbursed in all countries. Poland exhibited the highest MS expenditures in 2021, totaling 171 million euros. Administrative procedures for prescribing and dispensing MS drugs were similar across countries, but the range of services and support offered to MS patients varied. Assessment of treatment accessibility, based on the number of authorized DMTs listed in Positive Drug Lists (PDLs), shows Bulgaria leading with 84.21% access, followed closely by Poland and Slovakia with comparable rates of 78.95%. CONCLUSIONS: The study revealed disparities in health care and services for MS patients across the countries surveyed. Addressing these disparities and the need for targeted interventions to ensure equitable access is critical. Further research is needed to find effective solutions.

Clinic of neurology University hospital Alexandrovska Sofia Bulgaria

Faculty of Pharmacy Medical University of Sofia Sofia Bulgaria

Jagiellonian University Medical College Institute of Public Health Kraków Poland

Masaryk University Brno Czech Republic

Titu Maiorescu UNIV Bucharest Romania

University of Belgrade Belgrade Serbia

University of Tartu Tartu Estonia

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