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.
More about the projectPoland
In Poland, most significant barriers in diagnosis and treatment access were observed in chronic diseases.
Czech Republic
In Czechia, particularly good results were achieved in terms of access to healthcare in the area of rare diseases.
Slovakia
In Slovakia, the level of limitations in health care access is quite similar across all the therapeutic areas considered, with best results in rare diseases.
Hungary
Hungary saw the biggest improvement compared to the results of the previous edition, but it is still the country with the lowest overall GAP score.
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)
GAP analysis for NSCLC revealed moderate restrictions in access to both diagnosis and treatment. The combined indicator varies moderately across the countries with differences of about 10 points.
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Breast cancer
In all Visegrád (V4) countries, despite improvements in health outcomes for breast cancer patients in recent years, further problem solving discussions are needed to enhance healthcare delivery.
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Prostate cancer
Moderate limitations in the access to prostate cancer diagnosis and treatment were found in the Visegrád (V4) countries.
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Ovarian cancer
Moderate to severe constraints in access to ovarian cancer treatment and diagnosis in Visegrád (V4) countries have been revealed in the GAP score analysis.
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Cystic fibrosis
Constraints in access to cystic fibrosis treatment and diagnosis vary dramatically in the region with the difference between the highest and the lowest-scoring country of about 35 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 moderate 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
Severe to moderate restriction in access to SMA diagnosis and treatment has been identified in the Visegrád (V4) countries as measured in the GAP score.
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Diabetes mellitus
The substantial restrictions in diagnosis and access to diabetes mellitus have been identified in the Visegrád (V4) states as measured in the GAP score, with a clear difference between them.
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Multiple sclerosis
Moderate restrictions in access to multiple sclerosis treatment and diagnosis have been identified in the Visegrád (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 (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 (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 result in the area of oncology is the best among the compared 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 oncology and lower and almost the same result for both rare and chronic diseases.