OBJECTIVES: We aimed to conduct a patient-reported outcome study to reveal the barriers of using novel disease-modifying antirheumatic drugs (DMARDs) among patients with inflammatory arthritis in Hong Kong.

METHODS: This was a cross-sectional, patient-reported outcome study conducted between September 2021 and January 2022. Members from five local patient groups were invited to complete the paper-based questionnaire survey about the current utilization and barriers of access to novel DMARDs, disease-related healthcare resource utilization and productivity loss, and the mental health conditions of the surveyed patients.

RESULTS: Among 255 questionnaires distributed, we got 232 responses returned (initial response rate: 91%). 223 responses with more than 85% of questions completed were included in the final analysis (overall completion rate: 87.5%). The average age of the analyzed cohort was 54.1 years, and 52.5% were female. The most prevalent autoimmune disease was ankylosing spondylitis (53.4%), followed by psoriasis (39.5%), psoriatic arthritis (22.9%) and rheumatoid arthritis (9.9%). On average, patients suffered from the disease for 15 years or more. Treatment efficacy, probability of having severe adverse events and government or charity subsidization were the top three reasons when the patients considered using DMARDs. Patients with autoimmune diseases also suffered from mental health issues (52.1% of patients had depression and 15.1% of patients had anxiety). People’s maximum willingness to pay on DMARDs against autoimmune diseases was around HK$ 3400 per month, accounting for 30% of the self-reported monthly income on average. Only 20% of the patients applied Samaritan Fund successfully. Patients had to wait for a long time, usually exceeding two months, even more than one year, from making an outpatient appointment, to receiving the outpatient services.

CONCLUSIONS: The high cost, poor availability of subsidies, and delayed access to health services hindered the patients' use of DMARDs. Mental health issues happened commonly in patients with autoimmune disease.