Presentation (CTI)

OBJECTIVES: To assess trends in reimbursement access to disease-modifying therapies (DMTs) for multiple sclerosis (MS) and MS-related sickness absence in Poland between 2018 and 2025.
METHODS: A composite reimbursement access index was developed using three weighted dimensions: reimbursement scope relative to the regulatory indication (weight: 0.6), time from marketing authorization to HTA submission (weight: 0.1), and time from authorization to reimbursement availability (weight: 0.3). Each dimension was scored on a normalized scale (0, 0.33, 0.66, 1), and annual index values were calculated for 2018-2025 across EMA-authorized MS DMTs. Social Insurance Institution (ZUS) data on sickness absence among insured workers due to ICD-10 code G35 were analyzed, including annual sickness absence days and medical certificates. Data from 2020 were interpreted cautiously because COVID-19 affected sickness absence patterns.
RESULTS: The reimbursement access index increased from 0.462 in 2018 to 0.629 in 2025, with the largest gains from 2022 onwards, driven by new therapies, broader eligibility criteria, and additional patient populations. During the same period, annual MS-related sickness absence days decreased from 232,911 in 2018 to 206,759 in 2025 (−11.2%). Certificates increased from 18,727 to 26,366, while average duration per certificate decreased from 12.4 to 7.8 days, suggesting a shift toward shorter, more frequent absences among employed individuals with MS.
CONCLUSIONS: Between 2018 and 2025, increasing formal reimbursement access to MS DMTs in Poland occurred alongside fewer total sickness absence days and shorter average absence episodes among insured workers with MS. These findings suggest concurrent positive changes in treatment access and work-related outcomes. As the index reflects formal reimbursement provisions rather than real-world access, findings should be interpreted in the context of healthcare financing constraints affecting actual patient enrollment.