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Access to biologicals in Crohn's disease in ten European countries

World Journal of Gastroenterology 2017年第34期23卷 6294-6305页

作者： Márta Péntek Peter L Lakatos Talitha Oorsprong László Gulácsi milena pavlova Wim Groot Fanni Rencz Valentin Brodszky Petra Baji Crohn’s Disease Research Group department of health economics corvinus university of budapest mcgill university muhcmontreal general hospital 1st department of internal medicine semmelweis university department of health services research caphrimaastricht university medical centrefaculty of healthmedicine and life sciencesmaastricht university top institute evidence based education research (tier) teachers academymaastricht university 不详

AIM To analyze access(availability, affordability and acceptability) to biologicals for Crohn's disease(CD) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic *** A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, Latvia, Poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals. An availability score was developed to evaluate the restrictiveness of eligibility and administrative criteria applied in the countries. Affordability was defined as the annual cost of treatment as a share of gross domestic product(GDP) per capita. Correlations with the uptake of biologicals, dimensions of access and GDP per capita were *** At the time of the survey, infliximab and adalimumab were reimbursed in all ten countries, and vedolizumab was reimbursed in five countries(France, Germany, Latvia, Slovakia, Sweden). Reimbursement criteria were the least strict in Sweden and Germany, and the strictest in Hungary, Poland and Slovakia. Between countries, the annual cost of different biological treatments differed 1.6-3.3-fold. Treatments were the most affordable in Sweden(13%-37% of the GDP per capita) and the least affordable in the Central and Eastern European countries, especially in Hungary(87%-124%) and Romania(141%-277%). Biosimilars made treatments more affordable by driving down the annual costs. The number of patients with CD on biologicals per 100000 population was strongly correlated with GDP per capita(0.91), although substantial differences were found in the uptake among countries with similar economic development. Correlation between the number of patients with CD on biologicals per 100000 population and the availabi

关键词： Crohn’s disease Biological therapy Access Inequality Europe

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