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European Patients Often Denied Innovative Drugs -- Report

Jan 21, 2003
By Emily Hayes
Reuters Health

Patients in Europe lack access to modern drugs for a range of common medical conditions such as depression, rheumatoid arthritis and asthma, according to an industry sponsored report that largely blames meagre health budgets.

The report, Diffusion of Medicines in Europe, measures access to innovative medicines for 20 diseases, based on a review of recent medical literature. It was released Tuesday afternoon by the European Federation of Pharmaceutical Industries and Associations (EFPIA), which contracted German health economist Professor Oliver Schoffski to conduct the research.

"There is a general lack of provision of pharmaceuticals all over Europe. It is not a problem in just one country or for one disease...This is astonishing," said Schoffski, chair of health management at the University of Erlangen-Nuremberg.

"The [main] problem is that financial resources are scarce and doctors are obligated to use cheap drugs -- they are not free to prescribe modern drugs," he told Reuters Health.

Previous studies have shown gaps in treatment, but they have typically looked only at specific countries. The latest report provides an overview of care using national studies published from 1995 to 2002.

For example, a French study found 150,000 to 200,000 people with Alzheimer's disease could benefit from treatment with modern medicines to reduce disease progression, but only 56,000 received the drugs. Another showed that fewer than 50% of French multiple sclerosis patients eligible for treatment with beta interferons actually received them.

Of the 4 million asthma sufferers in Germany, studies suggest only one in three received treatment at all, and those who are treated may be inappropriately medicated.

Germany also lagged behind other European countries when it came to the provision of selective serotonin reuptake inhibitors (SSRI) for depression, which were provided to only 4% of eligible patients, according to literature reviewed by Schoffski.

Across Europe, access to statins to treat high cholesterol appeared to be very limited. For example, this treatment was given to about 36% of appropriate patients in the Netherlands and only 23% of patients in the UK.

Schoffski said it was hard to say which European country has the most restricted access to innovative medicines, because of variations in care within each particular nation.

Several factors were behind what the report describes as "sub-optimal treatment" of patients, including lack of awareness of innovative medicines among patients and prescribing doctors, and limited access to specialists.

But Schoffski concluded that the most important factor was that government budgets were not big enough to cover newer pharmaceuticals -- and the problem is likely to worsen.

"Dozens of innovations are on the way and they are very expensive. This is a critical situation and they [healthcare officials] have to figure out how to get patients the medicine they need with limited resources," he said.

Schoffski suggested the first step was to identify diseases where the gap between actual treatment and optimal treatment is biggest, and to prioritise these areas for action.

© 2003 Reuters Ltd