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Disparities in the organisation of national healthcare systems for treatment of patients with psoriatic arthritis and axial spondyloarthritis across Europe

2025Artigo científico Acesso aberto
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dc.contributor.authorMichelsen, Brigitte
dc.contributor.authorØstergaard, Mikkel
dc.contributor.authorNissen, Michael John
dc.contributor.authorCiurea, Adrian
dc.contributor.authorMöller, Burkhard
dc.contributor.authorMidtbøll Ørnbjerg, Lykke
dc.contributor.authorHorák, Pavel
dc.contributor.authorGlintborg, Bente
dc.contributor.authorMacDonald, Alan
dc.contributor.authorLaas, Karin
dc.contributor.authorSokka-Isler, Tuulikki
dc.contributor.authorGudbjornsson, Bjorn
dc.contributor.authorIannone, Florenzo
dc.contributor.authorHellamand, Pasoon
dc.contributor.authorKvien, Tore Kristian
dc.contributor.authorRodrigues, Ana Maria
dc.contributor.authorCodreanu, Catalin
dc.contributor.authorRotar, Ziga
dc.contributor.authorCastrejón, Isabel
dc.contributor.authorWallman, Johan Karlsson
dc.contributor.authorPavelka, Karel
dc.contributor.authorLoft, Anne Gitte
dc.contributor.authorHeddle, Maureen
dc.contributor.authorVorobjov, Sigrid
dc.contributor.authorRelas, Heikki
dc.contributor.authorGröndal, Gerdur
dc.contributor.authorGremese, Elisa
dc.contributor.authorvan der Horst-Bruinsma, Irene
dc.contributor.authorKristianslund, Eirik Klami
dc.contributor.authorSantos, Maria
dc.contributor.authorMogosan, Corina
dc.contributor.authorTomsic, Matija
dc.contributor.authorDiaz-Gonzalez, Federico
dc.contributor.authorGiuseppe, Daniela Di
dc.contributor.authorNielsen, Stig Winther
dc.contributor.authorHetland, Merete Lund
dc.date.accessioned2025-06-03T14:14:02Z
dc.date.available2025-06-03T14:14:02Z
dc.date.issued2025
dc.description© 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/)pt_PT
dc.description.abstractBackground: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHealth Policy. 2025 Jun:156:105311pt_PT
dc.identifier.doi10.1016/j.healthpol.2025.105311pt_PT
dc.identifier.eissn1872-6054
dc.identifier.issn0168-8510
dc.identifier.urihttp://hdl.handle.net/10400.5/101243
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/health-policypt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAccess to health carept_PT
dc.subjectAxial spondyloarthritispt_PT
dc.subjectBiologic therapypt_PT
dc.subjectHealth policypt_PT
dc.subjectPsoriatic arthritispt_PT
dc.subjectSocioeconomic health disparitiespt_PT
dc.titleDisparities in the organisation of national healthcare systems for treatment of patients with psoriatic arthritis and axial spondyloarthritis across Europept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleHealth Policypt_PT
oaire.citation.volume156pt_PT
person.familyNameSantos
person.givenNameMaria Jose
person.identifier.ciencia-id441A-CD98-8FD6
person.identifier.orcid0000-0002-7946-1365
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication288e25e9-3f56-4cab-afff-0cda5478f1ba
relation.isAuthorOfPublication.latestForDiscovery288e25e9-3f56-4cab-afff-0cda5478f1ba

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FM - Artigos em Revistas Internacionais
IMM - Artigos em Revistas Internacionais