Access to Medicines, Care, and Services for Multiple Sclerosis Patients in Central and Eastern European Countries: A Comparative Analysis

Speaker(s)

Seitaridou Y1, Paveliu MS2, Holko P3, Grega D4, Tadic I5, Stevic I5, Männik A6, Chamova T7, Petrova G8, Kamusheva M1
1Faculty of Pharmacy, Medical University of Sofia, Sofia, 22, Bulgaria, 2Titu Maiorescu UNIV, Bucharest, B, Romania, 3Jagiellonian University Medical College Institute of Public Health, Kraków, Poland, 4Masaryk University, Brno, Czech Republic, 5University of Belgrade, Belgrade, B, Serbia, 6University of Tartu, Tartu, Tartu, Estonia, 7Clinic of neurology, University hospital "Alexandrovska", Sofia, Bulgaria, Bulgaria, 8Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria

Presentation Documents

OBJECTIVES: To compare the access of patients with multiple sclerosis (MS) to disease-modifying treatments (DMTs), care, and services in Central and Eastern European countries (CEECs).

METHODS:: A 2-part questionnaire-based survey was conducted among experts from six CEECs – Bulgaria, Estonia, Poland, Romania, Serbia, and Slovakia over 4 months (01.12.2022 – 01.04.2023). The first part included questions about access to DMTs – legal requirements about reimbursement and pricing, availability of national pharmacotherapeutic and Health Technology Assessment guidelines, reimbursed DMTs, expenditures for three years (2019 – 2021) from the National Health Insurance Funds (NHIFs) perspectives. The second part included questions about MS patients’ physical and financial access to other services and support.

RESULTS: Markov modeling is acceptable in Bulgaria, Poland, Slovakia and Serbia, while meta-analysеs of conducted clinical trials are requested in Bulgaria and Poland. In 2019 - 2021, DMTs’ costs increаsed over time, with the highest MS expenditures observed in Poland (€1.15 billion in 2021). All countries provide access to different services and support for MS patients depending on patients disability level. Romania, Estonia, and Serbia ensure complete inpatient care, physiotherapy, and rehabilitation for MS patients. In all CEECs included in the study, the available DMTs were fully reimbursed, and NHIFs completely covered all diagnostic tests and procedures. Assessed by the number of authorized DMTs included in their Positive Drugs Lists, the best access to MS therapy have Bulgaria (84,21%), Poland (78,95%), and Slovakia (78,95%).

CONCLUSIONS: The study revealed differences in MS patients access to DMTs, care, and services amongst included countries. Improving access to MS therapy needs an evaluation of the long-term impact of the barriers as well as frequent feedback from MS patients and stakeholders.

Code

HSD113

Topic

Health Policy & Regulatory, Health Technology Assessment

Topic Subcategory

Public Spending & National Health Expenditures, Reimbursement & Access Policy, Systems & Structure

Disease

Neurological Disorders