Outcomes Research, Merck Sharp & Dohme, Edificio Vasco da Gama, nº 19 , 2770-192, Paço de Arcos, Portugal,
Eur J Health Econ. 2013 Dec;14(6):875-85. doi: 10.1007/s10198-012-0432-5. Epub 2012 Sep 18.
Despite the widespread availability of biologics across Europe, rheumatoid arthritis (RA) patients' access to these drugs differs significantly among countries.
To compare the proportion of RA patients treated with biologics across Europe and investigate the factors that most influence it, with focus on the Portuguese case, reportedly with low access rates to biologics.
The biologics' market was characterized for 15 selected European countries. Variables potentially influencing patients' access to biologics (PAB) in RA were also collected, including demographic, disease, economic, funding and biologics' market-related data. A multivariable regression model identified the factors that best explain PAB. Based on these determinants, a cluster analysis was performed to group the countries with most similar behaviour regarding PAB allowing the evaluation of Portugal's relative position among these countries.
The regression model (R(2) = 0.953) indicated that PAB in selected countries is explained mostly by its gross domestic product (GDP) per capita, the usage of methotrexate (MTX) and the biologics' distribution channel. Current MTX usage in Portugal shows similarity with practice from UK, France, Germany or Spain 5 years before, explaining why PAB in Portugal stood at 7% in 2010, 12 percentage points below the average of selected countries.
Variations in RA PAB were found across selected countries with Portugal showing the lowest proportion. GDP per capita, biologics distribution channel and consumption of MTX appear to be the best explanatory factors for these fluctuations in European countries.
尽管生物制剂在欧洲广泛应用，但各国类风湿关节炎（RA）患者获得这些药物的机会存在显著差异。
比较欧洲各国接受生物制剂治疗的 RA 患者比例，并探讨影响这一比例的因素，重点关注葡萄牙的情况，据称该国生物制剂的可及性较低。
对 15 个选定的欧洲国家的生物制剂市场进行了特征描述。还收集了可能影响 RA 患者接受生物制剂治疗（PAB）的变量，包括人口统计学、疾病、经济、资金和生物制剂市场相关数据。采用多变量回归模型确定了最能解释 PAB 的因素。基于这些决定因素，进行聚类分析以将具有最相似 PAB 行为的国家进行分组，从而评估葡萄牙在这些国家中的相对地位。
回归模型（R²=0.953）表明，选定国家的 PAB 主要由其人均国内生产总值（GDP）、甲氨蝶呤（MTX）的使用和生物制剂的分配渠道来解释。葡萄牙目前 MTX 的使用情况与英国、法国、德国或西班牙 5 年前的使用情况相似，这解释了为什么葡萄牙 2010 年的 PAB 仅为 7%，比选定国家的平均水平低 12 个百分点。
选定国家之间发现 RA PAB 存在差异，葡萄牙的比例最低。人均 GDP、生物制剂的分配渠道和 MTX 的使用似乎是欧洲国家 PAB 波动的最佳解释因素。
