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Access to an optimal treatment. Current situation.

Manuel F Ugarte-Gil1,2, Adriana M R Silvestre3, Bernardo A Pons-Estel4

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Access to optimal rheumatoid arthritis (RA) treatment in Latin America is limited by poverty, rural living, and lack of specialists. Many patients lack access to rheumatologists and biologic drugs, hindering effective disease management.

Keywords:
Access to healthcareDrug therapyHealth service accessibilityRheumatoid arthritis

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Area of Science:

  • Rheumatology
  • Health Economics
  • Public Health

Background:

  • Access to optimal treatment is influenced by availability, cost, and patient acceptance.
  • Latin America faces significant healthcare disparities, compounded by socio-demographic factors like poverty and rurality.
  • Rheumatoid arthritis (RA) management is challenged by delayed diagnosis and treatment due to inadequate specialist access in Latin America.

Purpose of the Study:

  • To analyze the multifaceted barriers to accessing optimal rheumatoid arthritis (RA) treatment in Latin America.
  • To highlight the impact of socio-demographic factors and healthcare system limitations on RA patient outcomes.
  • To underscore the need for improved epidemiological data for better rheumatic disease management in the region.

Main Methods:

  • Review of factors affecting treatment access, including specialist availability, drug coverage, and healthcare funding models.
  • Analysis of socio-demographic determinants of healthcare access in Latin America.
  • Examination of current public health system coverage for biologic disease-modifying antirheumatic drugs (bDMARDs).

Main Results:

  • Many Latin American cities lack rheumatologists, and primary care referral systems are inconsistent.
  • Biologic DMARD coverage in public health systems reaches less than 10% of RA patients in about half of the countries.
  • Healthcare funding decisions prioritize direct costs over patient-centered quality indicators, complicating access to new therapies.

Conclusions:

  • Significant barriers exist for rheumatoid arthritis (RA) patients in Latin America, including specialist shortages and limited access to advanced therapies.
  • Socio-demographic factors and healthcare system structures impede equitable access to RA treatment.
  • Accurate epidemiological data is crucial for enhancing the management of rheumatic diseases, particularly RA, in Latin America.