Autor(es):
Michelsen, Brigitte ; Østergaard, Mikkel ; Nissen, Michael John ; Ciurea, Adrian ; Möller, Burkhard ; Midtbøll Ørnbjerg, Lykke ; Horák, Pavel ; Glintborg, Bente ; MacDonald, Alan ; Laas, Karin ; Sokka-Isler, Tuulikki ; Gudbjornsson, Bjorn ; Iannone, Florenzo ; Hellamand, Pasoon ; Kvien, Tore Kristian ; Rodrigues, Ana Maria ; Codreanu, Catalin ; Rotar, Ziga ; Castrejón, Isabel ; Wallman, Johan Karlsson ; Pavelka, Karel ; Loft, Anne Gitte ; Heddle, Maureen ; Vorobjov, Sigrid ; Relas, Heikki ; Gröndal, Gerdur ; Gremese, Elisa ; van der Horst-Bruinsma, Irene ; Kristianslund, Eirik Klami ; Santos, Maria ; Mogosan, Corina ; Tomsic, Matija ; Diaz-Gonzalez, Federico ; Giuseppe, Daniela Di ; Nielsen, Stig Winther ; Hetland, Merete Lund
Data: 2025
Identificador Persistente: http://hdl.handle.net/10400.5/101243
Origem: Repositório da Universidade de Lisboa
Assunto(s): Access to health care; Axial spondyloarthritis; Biologic therapy; Health policy; Psoriatic arthritis; Socioeconomic health disparities
Descrição
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.
