PMID- 37651815
OWN - NLM
STAT- MEDLINE
DCOM- 20231110
LR  - 20231110
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 79
DP  - 2023 Nov
TI  - Barriers to accessing multiple sclerosis disease-modifying therapies in the 
      Middle East and North Africa region: A regional survey-based study.
PG  - 104959
LID - S2211-0348(23)00460-1 [pii]
LID - 10.1016/j.msard.2023.104959 [doi]
AB  - BACKGROUND: Multiple sclerosis (MS) management varies markedly between different 
      countries of the Middle East and North Africa (MENA) region based on the 
      availability and accessibility of disease-modifying therapies (DMTs). OBJECTIVE: 
      To evaluate the accessibility to DMTs in each MENA country, identify barriers to 
      treatment and make recommendations for improved access to DMTs across the region. 
      METHODS: This is a descriptive, survey-based study whereby we extracted data 
      collected, between October 2019 and April 2020, for countries in the MENA region 
      by the Multiple Sclerosis International Federation (MSIF) through their Atlas of 
      MS survey. RESULTS: 16 out of 19 countries in the MENA region were included in 
      this study. Sudan and Syria did not have any originator DMTs approved. 
      Interferons were the most widely low-efficacy originator approved DMTs. Three 
      countries did not have any high efficacy DMTs approved. Moreover, follow-on DMTs 
      were approved in half (50%) of the countries. Cost of treatment was the most 
      important barrier, reported in nearly half (47%) of the MENA countries. 
      CONCLUSION: Although most MENA countries have access to DMTs, more than half of 
      countries report problems with treatment continuation, highlighting the need for 
      a targeted regional strategy to address the variations in access to MS 
      treatments.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Zeineddine, Maya
AU  - Zeineddine M
AD  - Inserm U1094, IRD U270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology 
      of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical 
      Neurology, Omega Health, Limoges, France; Neurology Institute, Harley Street 
      Medical Center, Abu Dhabi, United Arab Emirates. Electronic address: 
      mzeineddine39@gmail.com.
FAU - Al-Hajje, Amal
AU  - Al-Hajje A
AD  - Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of 
      Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, 
      Lebanon.
FAU - Salameh, Pascale
AU  - Salameh P
AD  - Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of 
      Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, 
      Lebanon; School of Medicine, Lebanese American University, Byblos, Lebanon; 
      Department of Primary Care and Population Health, University of Nicosia Medical 
      School, Nicosia 2417, Cyprus.
FAU - Helme, Anne
AU  - Helme A
AD  - Multiple Sclerosis International Federation, London, United Kingdom.
FAU - Thor, Michael Gunnar
AU  - Thor MG
AD  - Multiple Sclerosis International Federation, London, United Kingdom.
FAU - Boumediene, Farid
AU  - Boumediene F
AD  - Inserm U1094, IRD U270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology 
      of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical 
      Neurology, Omega Health, Limoges, France.
FAU - Yamout, Bassem
AU  - Yamout B
AD  - Neurology Institute, Harley Street Medical Center, Abu Dhabi, United Arab 
      Emirates.
LA  - eng
PT  - Journal Article
DEP - 20230821
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - 9008-11-1 (Interferons)
SB  - IM
MH  - Humans
MH  - *Multiple Sclerosis/drug therapy/epidemiology
MH  - Middle East/epidemiology
MH  - Africa, Northern/epidemiology
MH  - Interferons
OTO - NOTNLM
OT  - Access
OT  - Barriers
OT  - Disease-modifying therapies
OT  - MENA
OT  - Multiple sclerosis
OT  - Treatment
COIS- Declaration of Competing Interest Maya Zeineddine has received honororia for 
      lectures from Biologix, Biogen, Janssen, Hikma Pharmaceuticals, Novartis, Merck, 
      Roche and Sanofi-Genyme. She received travel grants from Novartis, Merck and 
      Roche and a research grant from Biogen. She has no conflict of interest related 
      to this study. Amal Al-Hajje declares that there is no conflict of interest. 
      Pascale Salameh declares that there is no conflict of interest. Anne Helme and 
      Michael Gunnar Thor declare the following: Multiple Sclerosis International 
      Federation (MSIF) is an alliance of national multiple sclerosis (MS) 
      organizations. MSIF receives income from a wide range of sources, including 
      healthcare and other companies, individuals, member organizations, campaigns, 
      foundations and trusts. Over the last 5 years, MSIF received funding from the 
      following companies: Biogen, BristolMyersSquibb, Coloplast, Janssen, Merck, 
      Mylan, Novartis, Roche and Sanofi - all of which is publicly disclosed. MSIF has 
      not received any funding from industry for its access to medicines work in 2019, 
      2020, 2021 or 2022. Farid Boumediene declares that there is no conflict of 
      interest. Bassem Yamout has received speaker honoraria from Bayer, Biogen, Merck, 
      Novartis, Roche and Sanofi; research grants from Bayer, Biogen, Merck, Novartis 
      and Pfizer; and advisory board honoraria from Bayer, Biogen, Merck, Novartis, 
      Roche and Sanofi. He has no conflict of interest related to this study.
EDAT- 2023/09/01 00:42
MHDA- 2023/11/10 06:44
CRDT- 2023/08/31 18:03
PHST- 2023/05/02 00:00 [received]
PHST- 2023/08/20 00:00 [accepted]
PHST- 2023/11/10 06:44 [medline]
PHST- 2023/09/01 00:42 [pubmed]
PHST- 2023/08/31 18:03 [entrez]
AID - S2211-0348(23)00460-1 [pii]
AID - 10.1016/j.msard.2023.104959 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2023 Nov;79:104959. doi: 10.1016/j.msard.2023.104959. 
      Epub 2023 Aug 21.