Barriers to accessing biologic treatment for rheumatoid arthritis in Greece: the unseen impact of the fiscal crisis--the Health Outcomes Patient Environment (HOPE) study.
The latest regulatory change in the distribution system of biologic disease-modifying, antirheumatic drugs limited their sale only through the designated pharmacies of the National Organization for Healthcare Services Provision (EOPYY) or the National Health System (NHS) hospitals, adding to the complexity of access to effective treatment for rheumatoid arthritis (RA) in Greece. The aim of this paper was to assess the barriers to access RA treatment, by recording patients', rheumatologists' and EOPYY pharmacists' experiences. One twenty-three patients, 12 rheumatologists and 27 pharmacists from Athens and other urban areas in Greece participated in the study. Three types of standardized questionnaires were used to elicit information from each group of respondents using the method of personal interview for patients and the method of postal survey for doctors and pharmacists. During the last year, 26% of patients encountered problems in accessing their rheumatologist and 49% of patients experienced difficulties in accessing their medication. Ninety-two percent of rheumatologists and 96% of pharmacists confirmed that patients experience difficulties in accessing RA medication. The most commonly reported reasons for reduced access to medical treatment were travel difficulties and long distance from doctor's clinic, as well as delays in booking an appointment. The most frequently reported barriers to access pharmaceutical treatment were difficulties in the prescription process, distance from EOPYY pharmacies and medicine shortages in NHS hospitals. The study showed that RA patients are facing increased barriers to access timely and effective treatment. Redesign of the current system of distribution ensuring the operation of additional points of sale is deemed necessary.
Department of Health Policy, Faculty of Social Sciences, University of Peloponnese, Corinth, Greece, ksouliotis@uop.gr.
Kyriakos
K
Souliotis
Manto
M
Papageorgiou
Anastasia
A
Politi
Dimitrios
D
Ioakeimidis
Prodromos
P
Sidiropoulos
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics*; D001688:Biological Products / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000191:economics; D016527:Drug Costs; D057172:Economic Recession; D005260:Female; D006115:Greece; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D009819:Office Visits / Q000191:economics; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D012219:Rheumatology / Q000191:economics*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D001688:Biological Products