Analysis of access to treatment of patients with moderate and severe psoriasis within nationally founded treatment program “Treatment of moderate and severe form of plaque psoriasis (ICD-10 L 40.0)” in 2016–2021

Abstract

Introduction: Drug program B.47 “Treatment of moderate to severe form of plaque psoriasis (ICD-10 L 40.0)” has been operating since January 1, 2013. Since then, the description of the drug program has changed, and the funding and number of patients treated have increased as well. Material and methods: The publication uses data from NHF databases. The data for the years 2016–2021 were compiled and compared regarding the drug program B.47 “Treatment of moderate and severe plaque psoriasis (ICD-10 L 40.0)”. Results: In 2021, the drug program B.47 provided funding for 10 active substances: adalimumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, sekukinumab, tildrakizumab, ustekinumab. In the last 6 years of the B.47 drug program, the number of patients has grown dynamically and In 2021, there were 2,156 patients. Most patients are treated in the drug program in Mazowieckie Voivodship, and the least in Podlaskie Voivodship. Over the years 2016–2021, the most patients were treated with adalimumab, and the least with tildrakizumab, which was reimbursed from the second half of 2021. At the end of 2021, the program was implemented in Poland in 34 centers. The B.47 program is one of the smaller in terms of funding. The value of contracts for drugs in this program constitutes only approximately 1% of the total funds allocated for financing drugs in drug programs. Conclusions: The number of patients treated in B.47 is relatively low compared to other programs and represents only 1% of all patients treated under drug programs. When analyzing the number of patients currently undergoing treatment, it should be noted that only about 0.3% of the population of patients with psoriasis is under the care of doctors under the drug program, which is a very low indicator compared to other European countries, but also to the number of patients in other countries. At the same time, almost all biological drugs registered for the treatment of patients with moderate and severe disease are financed from public funds. For several years, the description of the drug program has been undergoing changes aimed at optimizing patients’ access to effective treatment. Currently, dermatologists together with organizations of patients with psoriasis, postulate the introduction of changes regarding the abolition of the treatment time limit for all drugs in the drug program B.47, and the transfer of TNF alpha blockers to reimbursement on the open list.