欧洲银屑病关节炎和轴性脊柱炎患者治疗的国家卫生保健系统组织的差异

IF 3.6 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Brigitte Michelsen , Mikkel Østergaard , Michael John Nissen , Adrian Ciurea , Burkhard Möller , Lykke Midtbøll Ørnbjerg , Pavel Horák , Bente Glintborg , Alan MacDonald , Karin Laas , Tuulikki Sokka-Isler , Bjorn Gudbjornsson , Florenzo Iannone , Pasoon Hellamand , Tore Kristian Kvien , Ana Maria Rodrigues , Catalin Codreanu , Ziga Rotar , Isabel Castrejón , Johan Karlsson Wallman , Merete Lund Hetland
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引用次数: 0

摘要

对生物制剂的国家政策进行研究是必要的。目的绘制和比较欧洲银屑病关节炎和轴性脊柱性关节炎患者生物/靶向合成疾病缓解抗风湿药物(DMARDs)的处方、开始、切换、逐渐减少和停药的国家卫生保健设置,并评估与各国社会经济状况相关的卫生保健设置。方法采用电子调查的方法收集和比较全国卫生保健系统的信息。采用线性回归方法评估生物/靶向合成DMARD法规累积得分、社会经济指标与生物始发成本之间的关系。结果15个国家的国家卫生保健设置差异很大,GDP/当前卫生支出/人类发展指数衡量的社会经济地位越高,法规越少,生物原产成本越高。在大多数国家,生物/靶向合成DMARD处方医生必须遵守国家和/或医院的建议,大约三分之一的国家设有国家/区域招标程序。生物/靶向合成dmard的处方规定,包括治疗前和疾病活动要求,有很大不同。大约三分之一的国家有停止和逐步减少的标准,而只有少数国家有转换标准。值得注意的是,两个国家不允许生物/靶向合成DMARD的再试验,一个国家对允许的生物/靶向合成DMARD的最大数量进行了限制。结论:研究结果强调了欧洲各地在银屑病关节炎和轴性脊柱性关节炎中使用生物/靶向合成DMARD的医疗保健设置的巨大差异,以及它们与社会经济地位和药物成本的关联。这些见解为风湿病学会、决策者和利益相关者评估和潜在优化医疗保健政策提供了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disparities in the organisation of national healthcare systems for treatment of patients with psoriatic arthritis and axial spondyloarthritis across Europe

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.
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来源期刊
Health Policy
Health Policy 医学-卫生保健
CiteScore
6.40
自引率
6.10%
发文量
157
审稿时长
3-8 weeks
期刊介绍: Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.
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