In a study presented at the European League Against Rheumatism Annual Congress, researchers demonstrated inequalities in access to biologics for the treatment of rheumatoid arthritis across 46 European countries — with 22% of countries having no biologics reimbursed whatsoever.
“Numerous clinical recommendations point to the role of biologic disease-modifying anti-rheumatic drugs (DMARDs) when targeting treatment of [rheumatoid arthritis] RA to [Disease Activity Score] DAS28 below 2.6, however, biologics are expensive and thus European countries with lower health care funding have restricted access to these treatments,” study author Polina Putrik stated in a European League Against Rheumatism news release.
Putrik’s team issued questionnaires to representative rheumatologists in 48 countries in the European region, collecting information on the number of reimbursed drugs, prices of biologics and the cultural acceptability of biologics for each country. Comparability was ensured through converting national prices into international dollars (int.$) and adjusting for each country’s purchasing power parity (PPP).
Socioeconomic welfare information for each country was also obtained, as well as data on each country’s RA health status. Access to biologics was then compared to welfare indicators and RA health status.
According to the study abstract, Putrik’s team received data from 46 countries. For 10 of these countries, no biologics were reimbursed. Five or more biologics were reimbursed in 26 countries. Affordability ranged across the countries as well, with costs as low as int.$14,446 to int.$92,074.
Putrik reported a moderate to strong positive correlation between economic welfare and the number of reimbursed drugs, as well as an inverse correlation between the number of reimbursed drugs and a country’s RA health status. After adjusting to PPP, the authors reported prices as strongly inversely correlated with economic welfare and positively with RA health.
“The findings of this study should alert health authorities to further strive toward optimal, EU-wide standards for access to care, because some of the patients who could benefit are being denied essential treatments,” Putrik stated.
- Putrik P, Ramiro S, Pavlova M, et al. Inequities in access to biologic DMARDs for patients with rheumatoid arthritis across 46 European countries. Ann Rheum Dis. 2012;71(Suppl3):665.