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Access to biologic treatment for rheumatoid arthritis in Central and Eastern European (CEE) countries.

Orlewska E, Ancuta I, Anic B, Codrenau C, Damjanov N, Djukic P, Ionescu R, Marinchev L, Nasonov EL, Peets T, Praprotnik S, Rashkov R, Skoupa J, Tlustochowicz W, Tlustochowicz M, Tomsic M, Veldi T, Vojinovic J, Wiland P - Med. Sci. Monit. (2011)

Bottom Line: Affordability index for biologic drugs was the lowest in Slovenia (0.4).In each country national guidelines define which patients are eligible for biologic treatment.Disease Activity Score (DAS28) of over 5.1 and failure of 2 or more disease-modifying anti-RA drugs, including methotrexate, are commonly used criteria.

View Article: PubMed Central - PubMed

Affiliation: Center for Pharmacoeconomics, Warsaw, Poland. ewaorlewska@go2.pl

ABSTRACT

Background: The aim of this study was to assess and compare patients' access to biologic anti-RA drugs in selected Central and Eastern European (CEE) countries and to analyze the determinants of differences between countries.

Material/methods: This is a multi-country survey study, based on a combination of desk research and direct contact with national RA stakeholders. Data was collected using a pre-defined questionnaire. Affordability was measured using an affordability index, calculated comparing the index of health care expenditures to the price index, using Poland as an index of 1.

Results: The percentage of patients on biologic treatment in 2009 was highest in Hungary (5% RA patients on biologic treatment), followed by Slovenia (4.5%), Slovakia (3.5%), Czech Republic (2.92%), Romania (2.2%), Estonia (1.8%), and Croatia, Serbia, Poland (below 1.5%). Infliximab, etanercept, adalimumab and rituximab were included in the reimbursement system in all countries, but abatacept and tocilizumab were included only in Slovakia. In Slovenia, public payer covered 75% of the price, and 25% is covered by supplementary health insurance; in Bulgaria public payer covered 50% of etanercept and adalimumab costs, and 75% of rituximab cost. In other countries, biologic drugs are reimbursed at 100%. Affordability index for biologic drugs was the lowest in Slovenia (0.4). In each country national guidelines define which patients are eligible for biologic treatment. Disease Activity Score (DAS28) of over 5.1 and failure of 2 or more disease-modifying anti-RA drugs, including methotrexate, are commonly used criteria.

Conclusions: The most important factors limiting access to biologic anti-RA treatment in the CEE region are macroeconomic conditions and restrictive treatment guidelines.

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Related in: MedlinePlus

Adalimumab in selected CEE countries: number of pack per 1000 inhabitants.
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f6-medscimonit-17-4-sr1: Adalimumab in selected CEE countries: number of pack per 1000 inhabitants.

Mentions: Data on utilization of RA biologic drugs over time are in most cases incomplete. This report only presents the analysis for countries where it was possible to derive necessary information. The graphs (Figures 4–6) show number of packs of biologic drugs used per 1,000 inhabitants in Croatia, Estonia, Hungary, Serbia, Slovakia and Slovenia during 2001–2008. Use of etanercept started after its re-launch in 2003. Hungary, Slovakia and Slovenia are the leading countries in etanercept use, joined since 2007 by Estonia. The use of infliximab increased more steadily and is highest in Hungary and Slovakia. Adalimumab was introduced after infliximab and etanercept, but its use was growing more rapidly in Slovenia, followed by Hungary, Slovakia and Estonia.


Access to biologic treatment for rheumatoid arthritis in Central and Eastern European (CEE) countries.

Orlewska E, Ancuta I, Anic B, Codrenau C, Damjanov N, Djukic P, Ionescu R, Marinchev L, Nasonov EL, Peets T, Praprotnik S, Rashkov R, Skoupa J, Tlustochowicz W, Tlustochowicz M, Tomsic M, Veldi T, Vojinovic J, Wiland P - Med. Sci. Monit. (2011)

Adalimumab in selected CEE countries: number of pack per 1000 inhabitants.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539513&req=5

f6-medscimonit-17-4-sr1: Adalimumab in selected CEE countries: number of pack per 1000 inhabitants.
Mentions: Data on utilization of RA biologic drugs over time are in most cases incomplete. This report only presents the analysis for countries where it was possible to derive necessary information. The graphs (Figures 4–6) show number of packs of biologic drugs used per 1,000 inhabitants in Croatia, Estonia, Hungary, Serbia, Slovakia and Slovenia during 2001–2008. Use of etanercept started after its re-launch in 2003. Hungary, Slovakia and Slovenia are the leading countries in etanercept use, joined since 2007 by Estonia. The use of infliximab increased more steadily and is highest in Hungary and Slovakia. Adalimumab was introduced after infliximab and etanercept, but its use was growing more rapidly in Slovenia, followed by Hungary, Slovakia and Estonia.

Bottom Line: Affordability index for biologic drugs was the lowest in Slovenia (0.4).In each country national guidelines define which patients are eligible for biologic treatment.Disease Activity Score (DAS28) of over 5.1 and failure of 2 or more disease-modifying anti-RA drugs, including methotrexate, are commonly used criteria.

View Article: PubMed Central - PubMed

Affiliation: Center for Pharmacoeconomics, Warsaw, Poland. ewaorlewska@go2.pl

ABSTRACT

Background: The aim of this study was to assess and compare patients' access to biologic anti-RA drugs in selected Central and Eastern European (CEE) countries and to analyze the determinants of differences between countries.

Material/methods: This is a multi-country survey study, based on a combination of desk research and direct contact with national RA stakeholders. Data was collected using a pre-defined questionnaire. Affordability was measured using an affordability index, calculated comparing the index of health care expenditures to the price index, using Poland as an index of 1.

Results: The percentage of patients on biologic treatment in 2009 was highest in Hungary (5% RA patients on biologic treatment), followed by Slovenia (4.5%), Slovakia (3.5%), Czech Republic (2.92%), Romania (2.2%), Estonia (1.8%), and Croatia, Serbia, Poland (below 1.5%). Infliximab, etanercept, adalimumab and rituximab were included in the reimbursement system in all countries, but abatacept and tocilizumab were included only in Slovakia. In Slovenia, public payer covered 75% of the price, and 25% is covered by supplementary health insurance; in Bulgaria public payer covered 50% of etanercept and adalimumab costs, and 75% of rituximab cost. In other countries, biologic drugs are reimbursed at 100%. Affordability index for biologic drugs was the lowest in Slovenia (0.4). In each country national guidelines define which patients are eligible for biologic treatment. Disease Activity Score (DAS28) of over 5.1 and failure of 2 or more disease-modifying anti-RA drugs, including methotrexate, are commonly used criteria.

Conclusions: The most important factors limiting access to biologic anti-RA treatment in the CEE region are macroeconomic conditions and restrictive treatment guidelines.

Show MeSH
Related in: MedlinePlus