How to read the scale?
Brief explanation
The scale shows how big the GAP for a given country in the given area(s) and aspect(s) is. The numerous scale of 0-100, where 100 indicates no restrictions in the most accurate treatment or diagnosis and 0 represents lack of access to the preselected interventions or services, is presented as color scale with best results (75 points and more) painted in green, worst results (25 points or less) painted in violet and the wide range of medium results presented in blue. With the exception of the green subscale, the darker shade relates to worse results.
The combined scores for a given country and disease generally are low to medium, which indicates the high need for better treatment opportunities. In terms of the scale that means that the bars are painted mostly in blue, with the pale color indicating limited restrictions to the reference treatments or services and the deep blue representing the substantial gap in access to therapies.
How to read the scale?
The scale shows how big the GAP for a given country in the given area(s) and aspect(s) is...
The gap in access to therapies in V4 is high - it's time to act.
Although significant improvement has been observed in the last two decades in access to innovative therapies, there are several further critical points still to be taken care of in order to provide the most optimal treatment in the region. The GAP (GEARING UP ACCESS PROPOSAL FOR V4) tool prudently measured the access in selected therapeutic areas in the Visegrád Group (V4) countries (Poland, Hungary, Czechia, and Slovakia) with the optimal standard of care as a benchmark. The performed analysis allowed identification of certain lags in availability to care.
Despite the natural conformity of these likeminded countries, at least several differences can be observed in healthcare accessibility. For each country, there are therapeutical areas with better and worse situation. Overall, the access to care in the V4 is however far from optimal, which clearly confirms the instant need for intervention to improve access throughout the region.
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Poland
In Poland, most significant barriers in diagnosis and treatment access were observed in chronic diseases, whereas in rare diseases significant progress has been observed.
64
Czech Republic
In Czechia, particularly good results were achieved in terms of access to healthcare in the area of rare diseases.
53
Slovakia
Slovakia observed the highest level of restrictions in access to modern treatment and the largest decrease in the score achieved compared to the previous edition among the V4 countries.
53
Hungary
In Hungary, the average level of health care constraints is almost the same in all areas analysed.
It is time to act.
The analysis is based on the GAP indicator - an aggregated result of a multi-criteria, specific key indicator framework, which allows to compare the results for each indication and for each country on several levels in a flexible way. All indications are evaluated using 8 similar indicators capturing different aspects of patient access (including availability, affordability and accessibility of medicines as well as diagnostics) that resulted in a regretful conclusion that all V4 countries have substantial GAPs in health care access as measured in each of the 12 carefully selected diseases.
However, despite this unfortunate diagnosis, this unique analysis is not for blaming ourselves for the difficulties of an evidently complex issue, but to hopefully support decision makers and other stakeholders in adjusting for the upcoming innovations in health care in V4. Disclosed differences may become motivators to promote equal access to health care across V4 countries and indicate the directions of needed actions towards improvement for the stakeholders.
Disease landscape
Lung cancer (NSCLC)
The GAP analysis for non-small cell lung cancer (NSCLC) revealed moderate limitations in access to both diagnosis and treatment
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Breast cancer
In the V4 countries, a moderate level of restrictions was identified in access to both diagnosis and treatment of breast cancer assessed together. Overall GAP results in analysed countries are varying from 45 to 64 points.
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Prostate cancer
The GAP analysis revealed moderate limitations in access to ovarian cancer treatment and diagnosis in the Visegrad Group (V4) countries.
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Ovarian cancer
The GAP analysis revealed relatively modest limitations in access to ovarian cancer treatment and diagnosis in the Visegrad Group (V4) countries.
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Cystic fibrosis
The limitations in access to cystic fibrosis treatment and diagnosis in the V4 region vary considerably between countries - and the distance between the highest scoring countries, Czechia and Poland, and the lowest scoring Hungary is approximately 25 points.
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Leukemia (AML)
Significant constraints in access to AML diagnosis and treatment have been identified in the Visegrád (V4) countries.
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Lymphoma
A high level of restrictions in diagnosis and access to lymphoma treatment has been identified in the Visegrád (V4) countries as measured in the GAP score.
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SMA
Minor restriction in access to SMA diagnosis and treatment has been identified in the Visegrád Group (V4) countries as measured in the GAP score.
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Diabetes mellitus
Severe to moderate limitations in access to diabetes diagnosis as well as treatment were found in the Visegrad Group (V4) countries.
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Multiple sclerosis
Sigificant restrictions in access to multiple sclerosis treatment and diagnosis have been identified in the Visegrád Group (V4) countries as measured in the GAP score.
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Asthma
Moderate restrictions in access to asthma treatment and diagnosis have been identified in the Visegrád Group (V4) countries as measured in the GAP score.
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Parkinson's disease
Severe restrictions in access to Parkinson’s disease treatment and diagnosis have been identified in the Visegrád Group (V4) countries as measured in the GAP score.
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The high need for care improvement in V4 Read more
Disease landscape
Conclusion
There is a need for rapid improvement of health care in V4 countries. The reimbursement of novel drugs is delayed and the number of patients that could have been diagnosed or treated is significantly limited. It all has a direct effect on the quality of care. The situation is specific for each therapeutic area, but in general, it can be easily stated that all V4 countries have substantial GAPs in the access to medicines and diagnostics.
Cross-country overview
The GAPs in V4 are driven mainly by the reimbursement restrictions and limited number of technologies covered by the public payer.
Poland
The most considerable GAPs in the health care access are in chronic diseases. By contrast, the results in the area of oncology and rare diseases stands out favourably with those obtained in the other countries.
Czechia
The GAPs in treatment and diagnosis access are least significant in rare diseases. The result for chronic diseases although it indicates significant constraints to optimal treatment is also better than in the other countries
Slovakia
In Slovakia, the level of GAPs in health care access is quite similar across all the therapeutic areas considered, with the worst results in chronic diseases and the best performance for rare diseases.
Hungary
In Hungary, the level of GAPs in health care access is very similar across all the therapeutic areas considered, with the best performance in chronic diseases and slightly lower and almost the same result for both rare and oncologic diseases.