The Ministry of Health will withdraw public funding for medicines known as Sysadoa, used in the treatment of osteoarthritis.
These medicines cost the Spanish National Health System about 36 million euros annually. The affected drugs have three active ingredients and an association of two that are sold in 49 different pharmaceutical presentations and whose effectiveness has been the subject of constant controversy since they are on the market.
To this day no cure for osteoarthritis and is known all available treatments only limited to alleviate the symptoms of this disease that affects 17.5% of the adult population. Those affected have several ways to treat their symptoms :
– L os antiinflammatory non steroidal (NSAID).
– L os analgesics, opioids.
– L os SYSADOAs, which are the only drugs that are specifically authorized for this disease.
But Health welcomes the lack of unanimity among experts about the efficacy of Sysadoa as there are numerous studies: some of which show a placebo- like effectiveness of these drugs ; in others, the effectiveness seems to be somewhat superior, and similar to NSAIDs. For this reason This is the reason Health had been studying withdraw funding for some time, which will save 36 million euros annually.
The patient associations, the pharmaceutical industry and the Spanish Society of Rheumatology (SER) have declared themselves against withdrawing funding. According to Carmen Sánchez, of the board of directors of the Spanish Association with Osteoporosis and Osteoarthritis (Aecosar) who have been fighting for years so that these products do not lose public subsidies. “They say it doesn’t have much effectiveness, but it’s not true. What happens is that it is not like the anti-inflammatory, that you take it and take away your pain, it has a lack, it takes a while to take effect, ”he emphasizes. The treatment, which without financing will cost about 20 euros per month, is in his opinion an “economic effort” for many patients because, in general “it is not the only one they take.”
For Farmaindustria (the employer’s association of pharmaceutical companies) explains that osteoarthritis, being a chronic disease, requires medications that have the least side effects, something that Sysadoa meets. “Anti-inflammatories can only be suitable as attack and punctual treatments, given their safety profile, questionable in the long term. The de-financing of groups of medications such as joint chondroprotectors [Sysadoa] can only eventually lead to the growth of other more complex and expensive alternatives, such as intra-articular infiltrations or hip prostheses. ”
Francisco Blanco, a member of the SER, is also against de-financing: “If you rely on classical medicine and see that these drugs are similar to placebo in some studies, you would say that they should not be prescribed. But in a personalized treatment approach it is different. In osteoarthritis patients, placebo shows improvements in 40% of cases; Sysadoa sometimes reach 60%. Today we have studies to know with enough precision (80%) who will work. If we can select these people, we will go to a more rational use of the drug and it can be beneficial for many patients. ”
Blanco emphasizes that the population that suffers from osteoarthritis is usually over 50 years old, and very often, 65 years old, with which comorbidities are frequent. In these cases, the use of anti-inflammatories, the other most common alternative, is not always recommended. “Sysadoa are very safe drugs and I don’t think they should be withdrawn from financing in a general way.”
Osteoarthritis is a disease that mostly affects women, injures the cartilage of the joints especially in the knees and hands , but also occurs in the hip, feet and spine. It causes intense pain and reduces the mobility of those who suffer from it, it is also associated with psychological impacts due to the limitations that it entails in everyday life.
But Health has already made the decision and unless unexpected changes in a short period of time these drugs will lose the funding they currently have from the National Health System.