Geographic variation in consumption of biopharmaceuticals among juvenile patients in Norway

Abstract

BACKGROUND: Principles of equal access to health care are indisputable goals and important foundations of the Norwegian health policy. Juvenile arthritis represents a significant cause of short- and long-term morbidity for the patients. All patients are assumed to have equal need for equal treatment interventions regardless of residence in Norway. Juveniles not having sufficient effect of traditional medical treatment are in need of more aggressive therapy. The last decades have provided major medical advances in this field, introducing biopharmaceuticals as a treatment option. Biologics, such as TNF-α inhibitors are costly and under strict regulation by the government. Therefore the consumption of such pharmaceuticals should be equal across Norway and is investigated further. OBJECTIVE: The study assesses geographic variation in relation to consumption of biologics among juvenile patients in Norway. If a variation is found, possible explanations and significant factors will be stated. Patients from infants to 39 years of age were studied in the period between 2004 and 2007. METHOD: Multiple regression analyses are preformed investigating the causality and relationship between the dependent variable and possible explanatory variables. RESULTS: Significant evidence of geographic variation in the consumption of biologics is found. There are relatively large variation between the hospital trusts and number of patients receiving biologic therapy, showing a tendency of higher biologic consumption in Northern Norway. Especially Helse Finnmark has a high consumption compared to the national average. CONCLUSION: The analyses suggest relatively large geographic variations between the hospital trusts. There is a clear tendency of larger consumption in the northern parts of Norway. Additionally the consumption of biologics increases with age and with the time period investigated.