The multiple sclerosis patient’s journey in Poland – current diagnosis

Abstract

The multiple sclerosis patient’s journey in Poland was described based on the data collected by the Therapeutic Programme Monitoring System (System Monitorowania Programów Terapeutycznych, SMPT) between 2014 and 2018 and a National Health Fund (Narodowy Fundusz Zdrowia, NFZ) report entitled “NFZ on Health. Multiple Sclerosis.” It was found that about 90% of patients had their first multiple sclerosis diagnosis code (ICD-10: G35) assigned by a neurologist, usually during hospital stay in the department of neurology. Further patient management was usually continued in a neurology clinic. The waiting time for further outpatient and inpatient specialist (neurology) care after the first G35 diagnosis is more than 100 days. Before G35 diagnosis, patients most often presented with their first symptoms to neurological and ophthalmic clinics and were probably referred from these clinics for a magnetic resonance imaging. The analysis of the data from the Therapeutic Programme Monitoring System showed that the median time from the onset of the first symptoms to the diagnosis of multiple sclerosis was 7.4 months, and the median time from the diagnosis to initiation of first-line disease modifying treatment was 14.82 months. The length of time from the diagnosis to disease modifying therapy had a significant impact on the degree of disability. Patients treated with highly active second-line therapies accounted for 8.5% of all patients treated in drug programmes, and the increase in the number of patients on second-line regimens and expenditure on this programme were disproportionately lower compared to the first-line programme. A programme to improve the diagnosis and the quality of care for patients with multiple sclerosis should be developed in Poland to achieve better treatment outcomes. It is crucial to reduce the waiting time for diagnosis and the time interval between diagnosis and the onset of disease modifying treatment.