More Rheumatoid Arthritis and Psoriatic Arthritis Patients Waiting “Unacceptable” Times for Referral than a Decade Ago

Research shows that a third of patients are waiting three to six months to see a rheumatologist

HODDESDON, England--()--New research commissioned by Merck Sharp & Dohme Limited (MSD) highlights how, despite efforts by the NHS to reduce waiting times for patients with the debilitating diseases of rheumatoid arthritis (RA) and psoriatic arthritis (PsA), the number of patients facing ‘unacceptable’ delays to see a specialist has steadily increased by over 10% in the past 10 years.1

The online research, commissioned and funded by MSD and developed in partnership with the National Rheumatoid Arthritis Society (NRAS), was conducted by Kantar Health among 75 rheumatologists and 254 patients in the UK in September and October 2013.

Nearly a third (30%) of the 254 patients surveyed who were diagnosed with RA or PsA in the past two years (2011-2013) had waited more than 12 weeks to see a specialist rheumatologist after presenting with symptoms to their GP, compared with one fifth (20%) of those diagnosed in 2000-2005.1 Across the past 10 years, findings also show that one in 10 patients said they waited more than six months (24 weeks) for their first hospital consultation.1

The research found that for many patients, waiting times fell far outside of the British Society for Rheumatology (BSR)-recognised 12-week ‘window of opportunity’. This is a key timeframe within which to accurately diagnose and begin effective treatment, allowing for dramatic reduction in the risk of further pain and disability and their associated costs.2

Ailsa Bosworth, CEO of National Rheumatoid Arthritis Society, says: “The findings from this research are disappointing and raise three key issues: firstly, there is an urgent need to address the lack of public awareness about the symptoms and seriousness of rheumatoid arthritis and, secondly, we need to treat possible early RA like cancer and get people referred and to see a specialist within 2-4 weeks so there is also urgent need to address GP education and awareness. Finally, rheumatology services need to allocate early RA slots into routine follow-up clinics, if they don't have an early RA/inflammatory arthritis clinic, so that once referred, people can be seen quickly."

All of the rheumatologists surveyed, 100% (n=75) are in unanimous agreement that any wait for an initial specialist consultation beyond 12 weeks is ‘unacceptable’, with nearly three-quarters (70%) stating that any wait beyond even six weeks is ‘unacceptable’.1

The results come at a time when rheumatic diseases, which include RA and PsA, represent a large health problem for the UK, with the cost to society estimated at £5.7 billion a year and accounting for the loss of 10 million working days.2 The first few weeks after onset of symptoms is the optimal time to start early and aggressive treatment. When appropriate treatment is started early, associated medical costs, disability and work limitations of these diseases can all be reduced.2

There is agreement and support from the BSR for earlier treatment of moderate RA with biologics rather than conventional medications, as the latter are not as good at slowing, or even reversing radiological progression and this eventually translates as disability.2

The research found that patients (80%) and rheumatologists (87%) agree that treatment is key to controlling their condition, and for those patients receiving treatment with biologics, both patients (94%) and rheumatologists (95%) are in agreement with symptom relief/pain control as an important consideration. However, for those patients on biologics, 96% say that feeling well enough to do the things they want to do is their most important consideration for them, compared with 40% of rheumatologists who believe this would be the most important consideration for the patient.1

When it comes to expectations from treatment and care, key statistics include:

• Nearly three-quarters of rheumatologists (72%) and nearly two-thirds (59%) of patients would like the opportunity to discuss ‘quality of life’ (impact on life, work, relationships, emotional health) more fully than they currently tend to do.

• Nearly all (96%) patients receiving biologic therapies state that reducing their disease progression and feeling well enough to do the things they want to do are the two most important aspects of their treatment, with side effects a lower priority (82%).

• The majority of rheumatologists (85%) feel optimistic about the future of RA/PsA management and treatment but this level of optimism is not shared by patients, with just over half (52%) of those on biologics and a third (31%) of non-biologic patients feeling optimistic about their future.1

An overwhelming body of evidence shows that patient access to biologics in the UK is relatively poor compared with other EU countries, with restrictive treatment guidelines in England limiting access to biologic therapies for patients with RA until the Disease Activity Score reaches 5.1 and above, when the disease becomes severe.4

– Ends –

Notes to Editors:

About the Survey

The survey was jointly developed by Merck Sharp & Dohme Ltd. (MSD) and the National Rheumatoid Arthritis Society (NRAS). MSD commissioned and funded the online research.

The anonymous online survey explored both patients’ and physicians’ expectations and actual experiences with the management, treatment options and outcomes of RA and PsA.

The research was conducted by Kantar Health, a market research agency, between 2 September and 4 October, 2013. The survey evaluated results from 254 adults with rheumatoid arthritis or psoriatic arthritis (via NRAS’ membership), and 75 rheumatologists (via Kantar Health’s health care professional panel).

All of Kantar Health’s activities are in line with the Market Research Society (MRS) code of conduct.

About Rheumatoid Arthritis (RA)

RA is a chronic, debilitating inflammatory disease that causes swelling, stiffness, and loss of function in joints. RA usually affects the hands, feet and wrists, but can also spread to joints all over the body. Around 580,000 people in England have RA, with an estimated 26,000 new cases diagnosed each year.5 Onset usually begins in middle-age but the condition can also affect children and young adults.6

About Psoriatic Arthritis (PsA)

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints and connective tissue affecting up to 30% of individuals with psoriasis (a common skin disorder). Around 1 in 50 people in the UK have psoriasis. Early diagnosis and treatment is important in preventing long-term effects or limiting the extensive joint damage that can occur at any stage of the disease.7,8

About MSD

We believe the most important thing we make is a difference. We operate in more than 140 countries and through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products we work with customers to bring innovative healthcare solutions to those who need them the most. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programmes and partnerships. For more information visit www.msd-uk.com. MSD is a trade name of Merck & Co., Inc., with headquarters in Whitehouse Station, N.J., U.S.A.

References

1. Rheumatoid Arthritis/PsA Patient and Physician Experience Survey. Carried out September/October 2013 by Kantar Health. Research funding supplied by MSD. Data on file. RHEU-1105926-0000

2. British Society for Rheumatology. Simple Tasks, Simple Asks: A Manifesto. Available from: http://www.rheumatology.org.uk/includes/documents/cm_docs/2013/m/1_manifesto.pdf. Accessed November 2013.

3. Deighton, C., Hyrich, K., Ding, T. et al. BSR and BHPR Rheumatoid Arthritis Guidelines on Eligibility Criteria for the First Biological Therapy. Rheumatology 2010; 49: 1197-99.

4. Costa-Font, J., Hockley, T. A Common Disease with an Uncommon Treatment: European Guideline Variations and Access to Innovative Therapies for Rheumatoid Arthritis. Policy Analysis Centre. Available from: http://www.policy-centre.com/downloads/Guideline-Variations-Report-2012-Final.pdf. Accessed November 2013

5. National Audit Office. Services for People with Rheumatoid Arthritis. Available from: http://www.nao.org.uk/publications/0809/services_for_people_with_rheum.aspx. Accessed November 2013

6. National Rheumatoid Arthritis Society (NRAS). What is RA? Available from: http://www.nras.org.uk/about_rheumatoid_arthritis/what_is_ra/what_is_ra.aspx. Accessed November 2013

7. National Psoriasis Foundation. Psoriatic Arthritis. Available from: http://www.psoriasis.org/NetCommunity/Document.Doc?id=912. Accessed November 2013.

8. Arthritis Research Campaign. Psoriatic Arthritis: Information Booklet. Available from: http://www.arthritisresearchuk.org/files/6029_PA_04-5_01032010141954.pdf. Accessed November 2013

Contacts

F Suleyman (MSD)
01992 455389
07974 444835
funda.suleyman@merck.com
or
Sallyanne Jones (Pegasus)
01903 836738
07799 781740
sjones@thisispegasus.co.uk

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Contacts

F Suleyman (MSD)
01992 455389
07974 444835
funda.suleyman@merck.com
or
Sallyanne Jones (Pegasus)
01903 836738
07799 781740
sjones@thisispegasus.co.uk