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      Biological Therapies in Immune-Mediated Inflammatory Diseases: Can Biosimilars Reduce Access Inequities?

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          Abstract

          Biological therapies are an effective treatment for a range of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis, psoriasis, and inflammatory bowel diseases. However, due to their high costs, considerable differences in their utilization exist across the world, even among the various European countries, with many countries restricting access despite professional society guideline recommendations. Adoption of biologics by healthcare providers has been particularly poor in many Central and Eastern European countries. Differences in utilization have also been observed across medical specialties, healthcare providers, and at a regional and national level. The objective of this paper is to provide an overview of the different market access policies for biologics in Europe and to investigate reasons for such differences. One of the potential solutions for providing broader access to IMID patients, where cost is the major barrier, is to encourage the use of biosimilars in place of their reference products. Biosimilars are generally less expensive alternatives to already licensed biological therapies and are approved on the basis that they are similar to the reference product in terms of quality, safety, and efficacy. Budget impact models predict considerable cost savings following the introduction of biosimilars in the next few years. These savings could be used to increase access to biologics and other innovative therapies.

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          3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management.

          This paper is the first in a series of two publications relating to the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the diagnosis and management of Crohn's disease and concerns the methodology of the consensus process, and the classification, diagnosis and medical management of active and quiescent Crohn's disease. Surgical management as well as special situations including management of perianal Crohn's disease of this ECCO Consensus are covered in a subsequent second paper [Gionchetti et al JCC 2016].
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            Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 2: Current Management.

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              Psoriasis and comorbid diseases: Epidemiology.

              Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.
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                Author and article information

                Contributors
                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                28 March 2019
                2019
                : 10
                : 279
                Affiliations
                [1] 1Inflammatory Bowel Disease Unit – Division of Gastroenterology, University of Alberta , Edmonton, AB, Canada
                [2] 2Department of Gastroenterology and Hepatology, Charité Medical School, Humboldt-University of Berlin , Berlin, Germany
                [3] 3Department of Dermatology, University Hospital of Brest , Brest, France
                [4] 4Fresenius Kabi , Eysin, Switzerland
                [5] 5Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Medical Sciences Division, University of Oxford , Oxford, United Kingdom
                Author notes

                Edited by: Sandor Kerpel-Fronius, Semmelweis University, Hungary

                Reviewed by: Brian Godman, Karolinska Institutet (KI), Sweden; Gaurav Deshpande, Bristol Myers Squibb, United States; Marc Henri De Longueville, UCB Pharma, Belgium

                *Correspondence: Daniel C. Baumgart, baumgart@ 123456ualberta.ca

                This article was submitted to Pharmaceutical Medicine and Outcomes Research, a section of the journal Frontiers in Pharmacology

                Article
                10.3389/fphar.2019.00279
                6447826
                30983996
                5b1dbd89-4b43-4b99-8504-6c33c59a4c84
                Copyright © 2019 Baumgart, Misery, Naeyaert and Taylor.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 11 December 2018
                : 05 March 2019
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 114, Pages: 13, Words: 0
                Categories
                Pharmacology
                Review

                Pharmacology & Pharmaceutical medicine
                rheumatoid arthritis,psoriasis,inflammatory bowel disease,biologic,biosimilar,patient access,pharmacoeconomics,utilization

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