title: Access to an optimal treatment. Current situation.
abstract: Access to an optimal treatment is determined by several factors, like availability, pricing/funding, and acceptability. In Latin America (LA), one of the regions with more disparities particularly on healthcare in the world, access is affected by other factors, including socio-demographic factors like poverty, living in rural regions, and/or health coverage. Regarding rheumatoid arthritis (RA), an inadequate access to specialists leads to diagnosis and treatment delays diminishing the probability of remission or control. Unfortunately, in almost every LA country, there are cities with more than 100,000 inhabitants without rheumatologists; furthermore, a primary care reference system is present in only about half the countries. In the public health system, coverage of biologic disease-modifying antirheumatic drugs occurs for less than 10 % of the patients in about half of the countries. Also, as healthcare providers based their funding decisions mainly in direct costs instead of on patient-centered healthcare quality indicators, access to new drugs is more complicated in this region than in high-income countries. More accurate epidemiological data from LA need to be obtained in order to improve the management of patients with rheumatic diseases in general and RA in particular.
authors.affiliation: Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.|Universidad Científica del Sur, Lima, Peru.
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Ugarte-Gil
authors.affiliation: Ministerio de Salud de la Provincia de Santa Fe, Rosario, Argentina.
authors.forename: Adriana M R
authors.initials: AM
authors.lastname: Silvestre
authors.affiliation: Servicio de Reumatología, Instituto Cardiovascular de Rosario, Rosario, Argentina. bponsestel@gmail.com.
authors.forename: Bernardo A
authors.initials: BA
authors.lastname: Pons-Estel
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics; D003365:Costs and Cost Analysis; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007843:Latin America; D011203:Poverty; D011320:Primary Health Care / Q000592:standards*
chemical_list: D018501:Antirheumatic Agents
keywords: Access to healthcare; Drug therapy; Health service accessibility; Rheumatoid arthritis