Correlation coefficients of the variables of access to DMARDs with socio-economic welfare and health status in 46 countries (27 EU member states)*
| Dimension of access | Indicator | GDP per capita in 2010, int. $ (n=19–46†) | Median income in 2009, int. $ (n=19–30†) | Total health expenditure in 2008, int. $ (n=19–46†) | DAS28 (mean) (n=12–21†) | SJC (mean) (n=12–21†) | HAQ (mean) (n=12–21†) |
|---|---|---|---|---|---|---|---|
| Availability | Biologic DMARDs approved; number | 0.86 (0.56) | 0.45 (0.41) | 0.79 (0.32) | −0.56 (−0.49) | −0.38 (−0.33) | −0.55 (−0.47) |
| Biologic DMARDs reimbursed; number | 0.88 (0.70) | 0.59 (0.64) | 0.83 (0.47) | −0.78 (−0.79) | −0.61 (−0.65) | −0.77 (−0.77) | |
| Reimbursement time; % of time since approval | 0.87 (0.70) | 0.66 (0.64) | 0.82 (0.50) | −0.66 (−0.59) | −0.45 (−0.37) | −0.69 (−0.63) | |
| Affordability | Average price of available biologic DMARDs; int. $/year | −0.84 (−0.79) | −0.75 (−0.78) | −0.83 (−0.73) | 0.75 (0.68) | 0.72 (0.67) | 0.75 (0.67) |
| Average patient contribution for available biologic DMARDs, int. $/year | −0.54 (−0.10) | −0.14 (−0.14) | −0.58 (−0.19) | 0.46 (0.33) | 0.76 (0.70) | 0.40 (0.26) | |
| Ratio annual price of available biologic DMARDs/GDP per capita | −0.91 (−0.91) | −0.94 (−0.85) | 0.83 (0.79) | 0.68 (0.65) | 0.84 (0.79) | ||
| Ratio annual personal contribution for available biologic DMARDs/minimum wage | −0.27 (−0.35) | −0.42 (−0.42) | −0.35 (−0.42) | 0.50 (0.52) | 0.80 (0.82) | 0.50 (0.52) | |
| Days a person receiving minimum wage has to work to cover 30 days treatment with available biologic DMARDs | −0.89 (−0.91) | −0.92 (−0.92) | −0.81 (−0.81) | 0.74 (0.76) | 0.63 (0.63) | 0.78 (0.80) | |
| Average price of available synthetic DMARDs, int. $/year | −0.52 (−0.72) | −0.65 (−0.63) | −0.44 (−0.54) | 0.88 (0.86) | 0.74 (0.68) | 0.81 (0.77) | |
| Average contribution for available synthetic DMARDs, int. $/year | −0.60 (−0.10) | −0.19 (−0.15) | −0.62 (−0.26) | 0.37 (0.22) | 0.34 (0.26) | 0.33 (0.14) | |
| Average price of all available synthetic DMARDs/GDP per capita | −0.86 (−0.86) | −0.88 (−0.76) | 0.88 (0.89) | 0.69 (0.69) | 0.87 (0.86) | ||
| Average annual personal contribution for available synthetic DMARDs/minimum wage | −0.51 (−0.48) | −0.51 (−0.51) | −0.60 (−0.58) | 0.52 (0.59) | 0.24 (0.43) | 0.34 (0.40) | |
| Days a person receiving minimum wage has to work to cover 30 days treatment with available synthetic DMARDs | −0.93 (−0.92) | −0.90 (−0.89) | −0.81 (−0.77) | 0.85 (0.88) | 0.66 (0.67) | 0.84 (0.84) | |
| Acceptability | Average score on 6 barriers | −0.63 (−0.36) | −0.37 (−0.33) | −0.66 (−0.47) | 0.69 (0.62) | 0.71 (0.73) | 0.58 (0.49) |
| Administration/financial barrier for prescribers | −0.49 (−0.38) | −0.39 (−0.37) | −0.53 (−0.53) | 0.59 (0.60) | 0.50 (0.45) | 0.55 (0.56) | |
| Amount of personal financial contribution from the patient | −0.46 (0.06) | 0.08 (0.13) | −0.45 (0.03) | 0.21 (−0.05) | 0.45 (0.34) | 0.21 (−0.05) | |
| Lack of trust in the healthcare system from patients | −0.48 (−0.32) | −0.37 (−0.30) | −0.51 (−0.43) | 0.64 (0.58) | 0.72 (0.66) | 0.55 (0.44) | |
| Overall score | Overall access score to biologic DMARDs (based on annual cost of treatment (int. $), number of biologic DMARDs reimbursed and average acceptability score) | 0.86 (0.76) | 0.69 (0.70) | 0.84 (0.69) | −0.83 (−0.83) | −0.78 (−0.86) | −0.78 (−0.76) |
*Correlation coefficient for all the countries appears first and the coefficient restricting the analyses to the 27 EU member states in parenthesis.
†n Corresponds to the minimum and maximum number of countries from which there were data for each of the correlations.
DAS, Disease Activity Score; DMARD, disease-modifying antirheumatic drug; GDP, Gross Domestic Product; HAQ, Health Assessment Questionnaire; int. $, international dollars; SJC, Swollen Joints Count.