Rheumatoid Arthritis Therapeutics in Philippines
Rheumatoid arthritis (RA) is one of the leading causes of significant debility among Filipinos, apart from asthma and cancer and about four times as many women as men have this disease. The prevalence is currently estimated to be approximately 0.06 percent National Nutrition & Health Survey (NNHeS) and is expected to increase to 0.07 percent by 2012. The treatment options are limited to conventional drugs such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs) as newer medications such as biologics are well beyond the affordability of the patients.
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“Recent work productivity studies have confirmed that better disease awareness and availability of treatment options have resulted in fewer patients ceasing to work and more patients reporting lower impact of their disease on work as well as family and social activities,” she further elaborates.
The future of RA drugs in
Methotrexate (MTX), a DMARD (disease-modifying anti-rheumatic drugs) has been traditionally used to treat RA. It is also the most used form of treatment in rheumatoid arthritis, especially with generic forms available. Currently, combination therapies between DMARDs and NSAIDs (non-steroidal anti-inflammatory drugs) are commonly practiced.
DMARDs capture the majority of the RA therapeutics market owing to the availability of reimbursement for treatment with these drugs and their easy availability over the counter. DMARDs are expected to retain majority share in the forecast period as well.
According to Rajan, “Biologics are used in combination with DMARDs for moderate to severe RA patients. Some biologic drugs are currently reimbursed, if treated in government hospitals. Physicians opine that with more drugs brought into the hospital formularies, the usage of biologics would increase for treatment earlier in the disease.”
Even though biologics are highly effective and recommended for treatment, they are likely to be the third line of treatment, due to their high cost. Physicians are willing to use biologics if they are listed in the hospital formulary and if they are affordable to their patients (current price range is seen to be out of reach of most patients). Physicians are of the opinion that more studies are required to make them feel confident in using biologics, but the cost of treatment is likely to restrain the high use of the drug class.
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