Gearing up. Assessment of patient access in the Visegrád countries.

Summary of the study prepared by AIPM (Hungary) and INFARMA (Poland), sponsored by EFPIA

Abstract

The Gearing Up Access Proposal for V4 project aimed to support a better understanding of the complex issue of access to innovative medicines and to identify potential intervention points and development possibilities in the Visegrad countries (Czech Republic, Poland, Hungary, Slovakia).

We assessed patient access in 10 indications including oncological, orphan, and chronic diseases. All indications were assessed by using the same set of 8 indicators, 6 of which related to the reimbursement of certain therapies approved in Europe since 2010, and 2 related to the availability of diagnostic pre-requisites of such therapies. All indicators were adapted to specific therapeutic areas in terms of relevant medicines and diagnostic tests and were calculated using publicly available data. The unique feature of our approach is that it takes into account the specificities of the Central European region, allows for flexible comparisons and aims to capture multiple aspects of patient access besides time to reimbursement. While a number of indicators have been developed and used to measure patient access, to our knowledge no existing measurement methodology is specific to our region and thus more accurately reflects our successes and shortcomings.

The highest cumulative gap was identified for rare diseases, as the number of available medicines is limited in all countries, especially in spinal muscular atrophy and cystic fibrosis. Results for oncological therapies are better, however, differences between the countries are significant, especially in ovarian and prostate cancer. The highest dispersion of results was observed in chronic diseases, especially diabetes mellitus.

For each country, there are therapeutical areas with better or worse access, but overall, the level of access to innovative therapies is below optimal in the region and there is a large gap: the aggregate score for each country ranges from 40 to 49 on a scale of 0-100, with lower scores indicating a larger gap. 

Our results indicate significant limitations in access to the latest therapeutic options and we assume that similar limitations exist in other diseases not included in this analysis. This confirms the urgent need for interventions to improve access to new innovative medicines throughout the region.