Publicação
Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide
| Resumo: | Objective: To establish in a global setting the relationships between countries' socioeconomic status (SES), measured biological disease modifying antirheumatic drug (bDMARD)-usage and disease outcomes. To assess if prescription and reimbursement rules and generic access to medication relates to a countries' bDMARD-usage. Methods: Data on disease activity and drug use from countries that had contributed at least 100 patients were extracted from the METEOR database. Mean disease outcomes of all available patients at the final visit were calculated on a per-country basis. A questionnaire was sent to at least two rheumatologists per country inquiring about DMARD-prices, access to treatment and valid regulations for prescription and reimbursement. Results: Data from 20 379 patients living in 12 different countries showed that countries' SES was positively associated with measured disease activity (meanDAS28), but not always with physical functioning (HAQ-score). A lower country's SES, stricter rules for prescription and reimbursement of bDMARDs as well as worse affordability of bDMARDs were associated with lower bDMARD-usage. bDMARD-usage was negatively associated with disease activity (although not with physical functioning), but the association was moderate at best. Conclusions: Disease activity in patients with rheumatoid arthritis as well as bDMARD-usage varies across countries worldwide. The (negative) relationship between countries' bDMARD-usage and level of disease activity is complex and under the influence of many factors, including - but not limited to - countries' SES, affordability of bDMARDs and valid prescription and reimbursement rules for bDMARDs. |
|---|---|
| Autores principais: | Bergstra, Sytske Anne |
| Outros Autores: | Branco, Jaime; Branco, Jaime; Vega-Morales, David; Salomon-Escoto, Karen; Govind, Nimmisha; Allaart, Cornelia F.; Landewé, Robert B.M. |
| Assunto: | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| Ano: | 2018 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| _version_ | 1865920607730794496 |
|---|---|
| author | Bergstra, Sytske Anne |
| author2 | Branco, Jaime Branco, Jaime Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. |
| author2_role | author author author author author author author |
| author_facet | Bergstra, Sytske Anne Bergstra, Sytske Anne Branco, Jaime Branco, Jaime Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. Branco, Jaime Branco, Jaime Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. |
| author_role | author |
| contributor_name_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) BMJ Publishing Group RUN |
| country_str | PT |
| creators_json_str | [{\"Person.name\":\"Bergstra, Sytske Anne\"},{\"Person.name\":\"Branco, Jaime\"},{\"Person.name\":\"Branco, Jaime\",\"Person.identifier.orcid\":\"0000-0001-7024-4375\"},{\"Person.name\":\"Vega-Morales, David\"},{\"Person.name\":\"Salomon-Escoto, Karen\"},{\"Person.name\":\"Govind, Nimmisha\"},{\"Person.name\":\"Allaart, Cornelia F.\"},{\"Person.name\":\"Landewé, Robert B.M.\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) BMJ Publishing Group RUN |
| datacite.creators.creator.creatorName.fl_str_mv | Bergstra, Sytske Anne Branco, Jaime Branco, Jaime Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. |
| datacite.date.Accepted.fl_str_mv | 2018-09-12T00:00:00Z |
| datacite.date.available.fl_str_mv | 2023-03-30T22:13:36Z |
| datacite.date.embargoed.fl_str_mv | 2023-03-30T22:13:36Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| datacite.titles.title.fl_str_mv | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Results from the METEOR-registry |
| dc.contributor.none.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) BMJ Publishing Group RUN |
| dc.creator.none.fl_str_mv | Bergstra, Sytske Anne Branco, Jaime Branco, Jaime Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. |
| dc.date.Accepted.fl_str_mv | 2018-09-12T00:00:00Z |
| dc.date.available.fl_str_mv | 2023-03-30T22:13:36Z |
| dc.date.embargoed.fl_str_mv | 2023-03-30T22:13:36Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10362/151432 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| dc.title.fl_str_mv | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Results from the METEOR-registry |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Objective: To establish in a global setting the relationships between countries' socioeconomic status (SES), measured biological disease modifying antirheumatic drug (bDMARD)-usage and disease outcomes. To assess if prescription and reimbursement rules and generic access to medication relates to a countries' bDMARD-usage. Methods: Data on disease activity and drug use from countries that had contributed at least 100 patients were extracted from the METEOR database. Mean disease outcomes of all available patients at the final visit were calculated on a per-country basis. A questionnaire was sent to at least two rheumatologists per country inquiring about DMARD-prices, access to treatment and valid regulations for prescription and reimbursement. Results: Data from 20 379 patients living in 12 different countries showed that countries' SES was positively associated with measured disease activity (meanDAS28), but not always with physical functioning (HAQ-score). A lower country's SES, stricter rules for prescription and reimbursement of bDMARDs as well as worse affordability of bDMARDs were associated with lower bDMARD-usage. bDMARD-usage was negatively associated with disease activity (although not with physical functioning), but the association was moderate at best. Conclusions: Disease activity in patients with rheumatoid arthritis as well as bDMARD-usage varies across countries worldwide. The (negative) relationship between countries' bDMARD-usage and level of disease activity is complex and under the influence of many factors, including - but not limited to - countries' SES, affordability of bDMARDs and valid prescription and reimbursement rules for bDMARDs. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://run.unl.pt/bitstreams/15ea93f8-1112-4009-b921-8470f977beb4/download |
| id | run_11bc3fe7d2df413f4a43fe3b9c9d5bbc |
| identifier.url.fl_str_mv | http://hdl.handle.net/10362/151432 |
| instacron_str | unl |
| institution | Universidade Nova de Lisboa |
| instname_str | Universidade Nova de Lisboa |
| language | eng |
| network_acronym_str | run |
| network_name_str | Repositório Institucional da UNL |
| oai_identifier_str | oai:run.unl.pt:10362/151432 |
| organization_str_mv | urn:organizationAcronym:unl |
| person_str_mv | Bergstra, Sytske Anne Branco, Jaime Branco, Jaime Branco, Jaime https://www.ciencia-id.pt/B612-E5C3-60DC B612-E5C3-60DC http://orcid.org/0000-0001-7024-4375 0000-0001-7024-4375 Vega-Morales, David Salomon-Escoto, Karen Govind, Nimmisha Allaart, Cornelia F. Landewé, Robert B.M. |
| publishDate | 2018 |
| reponame_str | Repositório Institucional da UNL |
| repository_id_str | urn:repositoryAcronym:run |
| service_str_mv | urn:repositoryAcronym:run |
| spelling | engenObjective: To establish in a global setting the relationships between countries' socioeconomic status (SES), measured biological disease modifying antirheumatic drug (bDMARD)-usage and disease outcomes. To assess if prescription and reimbursement rules and generic access to medication relates to a countries' bDMARD-usage. Methods: Data on disease activity and drug use from countries that had contributed at least 100 patients were extracted from the METEOR database. Mean disease outcomes of all available patients at the final visit were calculated on a per-country basis. A questionnaire was sent to at least two rheumatologists per country inquiring about DMARD-prices, access to treatment and valid regulations for prescription and reimbursement. Results: Data from 20 379 patients living in 12 different countries showed that countries' SES was positively associated with measured disease activity (meanDAS28), but not always with physical functioning (HAQ-score). A lower country's SES, stricter rules for prescription and reimbursement of bDMARDs as well as worse affordability of bDMARDs were associated with lower bDMARD-usage. bDMARD-usage was negatively associated with disease activity (although not with physical functioning), but the association was moderate at best. Conclusions: Disease activity in patients with rheumatoid arthritis as well as bDMARD-usage varies across countries worldwide. The (negative) relationship between countries' bDMARD-usage and level of disease activity is complex and under the influence of many factors, including - but not limited to - countries' SES, affordability of bDMARDs and valid prescription and reimbursement rules for bDMARDs.application/pdfenInequity in access to bDMARD care and how it influences disease outcomes across countries worldwideSubtitleenResults from the METEOR-registryBergstra, Sytske AnneBranco, JaimePersonalBranco, JaimeDSpacehttp://dspace.org/items/4caea9f3-40dd-4c95-98ec-0120509287c0DSpacehttp://dspace.org/items/4caea9f3-40dd-4c95-98ec-0120509287c0BrancoJaimeCiência IDhttps://www.ciencia-id.ptB612-E5C3-60DCORCIDhttp://orcid.org0000-0001-7024-4375Scopus Author IDhttps://www.scopus.com8417815400Vega-Morales, DavidSalomon-Escoto, KarenGovind, NimmishaAllaart, Cornelia F.Landewé, Robert B.M.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)BMJ Publishing GroupHostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf0003-4967URNIsPartOfPURE: 17364535URNIsPartOfPURE UUID: 11474cf2-6364-4e88-9b5a-fe6904cc023bURNIsPartOfScopus: 85049727717URNIsPartOfPubMed: 29980576URNIsPartOfWOS: 000446465700016DOIIsPartOf10.1136/annrheumdis-2018-2132892023-03-30T22:13:36Z2018-09-122018-09-12T00:00:00ZHandlehttp://hdl.handle.net/10362/151432http://purl.org/coar/access_right/c_abf2open accessdisease activityDMARDs (biologic)economic evaluationsrheumatoid arthritisImmunology and AllergyRheumatologyImmunologyGeneral Biochemistry,Genetics and Molecular Biology1554124 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/15ea93f8-1112-4009-b921-8470f977beb4/download |
| spellingShingle | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Bergstra, Sytske Anne disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology Bergstra, Sytske Anne disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| status | NEW |
| subject.fl_str_mv | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| title | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| title_full | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| title_fullStr | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| title_full_unstemmed | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| title_short | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| title_sort | Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide |
| topic | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| topic_facet | disease activity DMARDs (biologic) economic evaluations rheumatoid arthritis Immunology and Allergy Rheumatology Immunology General Biochemistry,Genetics and Molecular Biology |
| url | http://hdl.handle.net/10362/151432 |
| visible | 1 |