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Access to biologicals in Crohn’s disease in ten European countries
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 development. METHODS: A questionnaire-based survey combined with d...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603496/ https://www.ncbi.nlm.nih.gov/pubmed/28974896 http://dx.doi.org/10.3748/wjg.v23.i34.6294 |
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author | Péntek, Márta Lakatos, Peter L Oorsprong, Talitha Gulácsi, László Pavlova, Milena Groot, Wim Rencz, Fanni Brodszky, Valentin Baji, Petra Crohn’s Disease Research Group, |
author_facet | Péntek, Márta Lakatos, Peter L Oorsprong, Talitha Gulácsi, László Pavlova, Milena Groot, Wim Rencz, Fanni Brodszky, Valentin Baji, Petra Crohn’s Disease Research Group, |
author_sort | Péntek, Márta |
collection | PubMed |
description | 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 development. METHODS: 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 calculated. RESULTS: 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 availability and affordability was also strong (-0.75, -0.69 respectively). CONCLUSION: Substantial inequalities in access to biologicals were largely associated with GDP. To explain differences in access among countries with similar development needs further research on acceptance. |
format | Online Article Text |
id | pubmed-5603496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-56034962017-10-03 Access to biologicals in Crohn’s disease in ten European countries Péntek, Márta Lakatos, Peter L Oorsprong, Talitha Gulácsi, László Pavlova, Milena Groot, Wim Rencz, Fanni Brodszky, Valentin Baji, Petra Crohn’s Disease Research Group, World J Gastroenterol Observational Study 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 development. METHODS: 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 calculated. RESULTS: 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 availability and affordability was also strong (-0.75, -0.69 respectively). CONCLUSION: Substantial inequalities in access to biologicals were largely associated with GDP. To explain differences in access among countries with similar development needs further research on acceptance. Baishideng Publishing Group Inc 2017-09-14 2017-09-14 /pmc/articles/PMC5603496/ /pubmed/28974896 http://dx.doi.org/10.3748/wjg.v23.i34.6294 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Observational Study Péntek, Márta Lakatos, Peter L Oorsprong, Talitha Gulácsi, László Pavlova, Milena Groot, Wim Rencz, Fanni Brodszky, Valentin Baji, Petra Crohn’s Disease Research Group, Access to biologicals in Crohn’s disease in ten European countries |
title | Access to biologicals in Crohn’s disease in ten European countries |
title_full | Access to biologicals in Crohn’s disease in ten European countries |
title_fullStr | Access to biologicals in Crohn’s disease in ten European countries |
title_full_unstemmed | Access to biologicals in Crohn’s disease in ten European countries |
title_short | Access to biologicals in Crohn’s disease in ten European countries |
title_sort | access to biologicals in crohn’s disease in ten european countries |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603496/ https://www.ncbi.nlm.nih.gov/pubmed/28974896 http://dx.doi.org/10.3748/wjg.v23.i34.6294 |
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