Biological therapy in inflammatory bowel diseases: access in Central and Eastern Europe

被引:58
作者
Rencz, Fanni [1 ,2 ]
Pentek, Marta [1 ]
Bortlik, Martin [3 ]
Zagorowicz, Edyta [4 ,5 ,6 ]
Hlavaty, Tibor [7 ]
Sliwczynski, Andrzej [8 ]
Diculescu, Mihai M. [9 ]
Kupcinskas, Limas [10 ]
Gecse, Krisztina B. [11 ]
Gulacsi, Laszlo [1 ]
Lakatos, Peter L. [11 ]
机构
[1] Corvinus Univ Budapest, Dept Hlth Econ, H-1093 Budapest, Hungary
[2] Semmelweis Univ, Doctoral Sch Clin Med, H-1085 Budapest, Hungary
[3] Charles Univ Prague, IBD Clin & Res Ctr, ISCARE As, Fac Med 1, Prague 170004, Czech Republic
[4] Maria Sklodowska Curie Mem Canc Ctr, Dept Gastroenterol, PL-01813 Warsaw, Poland
[5] Inst Oncol, PL-01813 Warsaw, Poland
[6] Med Ctr Postgrad Educ, PL-01813 Warsaw, Poland
[7] Univ Hosp Bratislava, Dept Internal Med 5, Gastroenterol Unit, SK-82606 Bratislava, Slovakia
[8] Med Univ Lodz, Dept Publ Hlth, Fac Hlth Sci, PL-02390 Warsaw, Poland
[9] Carol Davila Univ, Dept Gastroenterol & Hepatol, Bucharest 020022, Romania
[10] Lithuanian Univ Hlth Sci, Med Acad, Dept Gastroenterol, LT-50009 Kaunas, Lithuania
[11] Semmelweis Univ, Dept Med 1, H-1083 Budapest, Hungary
关键词
Inflammatory bowel diseases; Ulcerative colitis; Biological therapy; Access; Europe; Central and Eastern; Crohn's disease; ULCERATIVE-COLITIS; CROHNS-DISEASE; RHEUMATOID-ARTHRITIS; COST-EFFECTIVENESS; WESTERN COUNTRIES; PREVALENCE; EPIDEMIOLOGY; INFLIXIMAB; MORTALITY; HUNGARY;
D O I
10.3748/wjg.v21.i6.1728
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Biological drugs opened up new horizons in the management of inflammatory bowel diseases (IBD). This study focuses on access to biological therapy in IBD patients across 9 selected Central and Eastern European (CEE) countries, namely Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania and Slovakia. Literature data on the epidemiology and disease burden of IBD in CEE countries was systematically reviewed. Moreover, we provide an estimation on prevalence of IBD as well as biological treatment rates. In all countries with the exception of Romania, lower biological treatment rates were observed in ulcerative colitis (UC) compared to Crohn's disease despite the higher prevalence of UC. Great heterogeneity (up to 96-fold) was found in access to biologicals across the CEE countries. Poland, Bulgaria, Romania and the Baltic States are lagging behind Hungary, Slovakia and the Czech Republic in their access to biologicals. Variations of reimbursement policy may be one of the factors explaining the differences to a certain extent in Bulgaria, Latvia, Lithuania, and Poland, but association with other possible determinants (differences in prevalence and incidence, price of biologicals, total expenditure on health, geographical access, and cost-effectiveness results) was not proven. We assume, nevertheless, that health deterioration linked to IBD might be valued differently against other systemic inflammatory conditions in distinct countries and which may contribute to the immense diversity in the utilization of biological drugs for IBD. In conclusion, access to biologicals varies widely among CEE countries and this difference cannot be explained by epidemiological factors, drug prices or total health expenditure. Changes in reimbursement policy could contribute to better access to biologicals in some countries.
引用
收藏
页码:1728 / 1737
页数:10
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