title: Rare diseases and orphan drugs: Latvian story.
abstract: BACKGROUND
  Ten years have passed since Latvia became a Member State of the EU in 2004. As a result European regulations, including those related to rare diseases and orphan drugs, have been applied to Latvian legislative system. Orphan diseases have been recognized as a priority area for action in the public health system, though there are significant differences in the national healthcare services for rare diseases among the EU States. This study aims to determine situation in the field of rare diseases in Latvia and compare it with other European countries.
  
  
  METHODS
  We used the national plan for rare diseases, EUCERD reports, Orphanet data, Latvian and European regulations, publicly available data from the state agencies, and directly contacted drug manufacturers and wholesalers.
  
  
  RESULTS
  National plan for rare diseases was developed and approved in 2013. Although there are no official designated centers of expertise as well as no specific register for rare diseases. Newborns are screened for only two disorders: phenylketonuria and congenital hypothyroidism. Currently 34 orphan drugs are available on Latvian market. Three medicines (8.8%) are included in the reimbursement drug list, all indicated for Ph + CML. 15 drugs (44.1%) were reimbursed within the framework of individual reimbursement system, and five drugs (14.7%) were provided within the program of medicinal treatment of rare diseases in children.
  
  
  CONCLUSIONS
  Majority of orphan drugs authorized in the EU are not available in Latvia, moreover those drugs that are available are often not accessible because they are insufficiently reimbursed. Besides, approval of the national plan might be an important step towards improving situation in the field of rare diseases.
authors.forename: Konstantins
authors.initials: K
authors.lastname: Logviss
authors.forename: Dainis
authors.initials: D
authors.lastname: Krievins
authors.forename: Santa
authors.initials: S
authors.lastname: Purvina
mesh_terms: D005060:Europe; D006801:Humans; D007844:Latvia; D007880:Legislation, Drug / Q000191:economics / Q000639:trends; D009313:National Health Programs / Q000191:economics / Q000639:trends*; D009965:Orphan Drug Production / Q000191:economics / Q000331:legislation & jurisprudence*; D035583:Rare Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*