Monitoring health inequity across Europe
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Rheumatic and musculoskeletal diseases (RMD) are the leading causes of disability worldwide, resulting in significant healthcare and social support costs. One of the reasons for this increasing burden seems to be the variability in the number and nature of allocated resources across Europe, as well as organisational aspects of health systems that result in disparities and health inequities across countries.

New work presented at the 2025 congress of EULAR – The European Alliance of Associations for Rheumatology – in Barcelona described RMD health-related indicators from all EULAR member countries, collected as part of the RheumaFacts project – a study identifying potential inequities between countries.

Data were collected on a diverse range of topics, including access to reimbursed physiotherapy and psychological care, the possibility for patients to self-refer to rheumatologists in the public sector, the number of rheumatology departments and rheumatologists, and treatment availability. So far, 31 countries have submitted data.

The findings show that the number of rheumatology departments per 100,000 inhabitants ranges from 0.02–0.9, and the vast majority (70%) were in non-academic centres. Within these, the number of rheumatologists per 100,0000 inhabitants ranged much more widely from 0.6–8.27. The absolute number of rheumatologists providing care to children was even more disparate, ranging from 4–84. Only 17 countries enabled self-referral to a rheumatologist in the public sector.

With regard to access to care, most countries (93%) had access to all available conventional systemic disease-modifying drugs (csDMARD), whereas only 37% and 47% had access to all biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), respectively. However, all but one country had at least one bDMARD available (mostly TNFi).

Only 63% reported having access to reimbursed physiotherapy for RMD patients on a chronic care basis, and only 30% reported having access to psychological care.

Speaking at the congress, lead author Anna Moltó said, “inter-country variability is high in Europe, with only around half of countries having full access to drugs and to reimbursed non-pharmacological treatments. RheumaFacts should allow us to monitor this, and we hope we will see inequities decrease in order to improve the overall health of patients living with RMD.”

Source
Moltó A, et al. Inequity in access to care for rheumatic and musculoskeletal diseases is a reality in Europe: first data from the EULAR Rheumafacts project. Presented at EULAR 2025; OP0025.
Ann Rheum Dis 2025; DOI: 10.1136/annrheumdis-2025-eular.B1313.