title: Access to Care for Multiple Sclerosis in Times of Economic Crisis in Greece--the HOPE II Study.
abstract: BACKGROUND
  While there is currently no cure for multiple sclerosis (MS), treatment with biologic disease-modifying drugs (bDMDs) can reduce the impact of the condition on the lives of patients. In Greece, the regulatory change in the distribution system of bDMDs, limited their administration through the designated pharmacies of the National Organization for Healthcare Services Provision (EOPYY) or the National Health System (ESY) hospitals, thus potentially impacting access to MS treatment. In this context, the aim of this paper was to assess the barriers to bDMDs, by recording MS patients' experiences.
  
  
  METHODS
  A survey research was conducted between January and February 2014 in Athens and 5 other major Greek cities with the methods of personal and telephone interview. A structured questionnaire was used to elicit socio-economic and medical information, information related to obstacles in accessing bDMDs and medical treatment, from MS patients that visited EOPYY pharmacies during the study period.
  
  
  RESULTS
  During the last year 69% of 179 participants reported that the distribution system of bDMDs has improved. Thirteen percent of participants encountered problems in accessing their medication, and 16.9% of participants in accessing their physician, with the obstacles being more pronounced for non-Athens residents. Frequent obstacles to bDMDs were the distance from EOPYY pharmacies and difficulties in obtaining a diagnosis from an EOPYY/ESY physician, while obstacles to medical care were delays in appointment booking and travel difficulties.
  
  
  CONCLUSIONS
  Even though the major weaknesses of the distribution system of bDMDs have improved, further amelioration of the system could be achieved through the home delivery of medicines to patients living in remote areas, and through the development of a national MS registry.
authors.affiliation: Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece.|Centre for Health Services Research, Medical School, University of Athens, Athens, Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Souliotis
authors.affiliation: Faculty of Social Sciences, University of Peloponnese, Corinth, Greece.|National Organization for Healthcare Services Provision, Athens, Greece.
authors.forename: Elena
authors.initials: E
authors.lastname: Alexopoulou
authors.affiliation: Faculty of Social Sciences, University of Peloponnese, Corinth, Greece.
authors.forename: Manto
authors.initials: M
authors.lastname: Papageorgiou
authors.affiliation: Department of Statistics, Athens University of Economics and Business, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Politi
authors.affiliation: Centre for Health Services Research, Medical School, University of Athens, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Litsa
authors.affiliation: Faculty of Social Sciences, University of Peloponnese, Corinth, Greece.
authors.forename: Xenophon
authors.initials: X
authors.lastname: Contiades
mesh_terms: D001688:Biological Products / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data*; D057172:Economic Recession; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics*; D009313:National Health Programs / Q000191:economics; D009819:Office Visits / Q000191:economics
chemical_list: D001688:Biological Products
keywords: Biologics; Greece; Multiple Sclerosis (MS); Patient Access; Pharmaceutical Policy; Recession