Biological therapy in inflammatory bowel diseases: Access in Central and Eastern Europe

Table 1 Incidence and prevalence of Crohn's disease and ulcerative colitis in the total population in 9 selected Central and Eastern European countries

Ref.	Country, region/city	Study period	Incidence/105		Prevalence/105
			CD	UC	CD	UC
Burisch et al[8], 20141	Czech Republic, Prague	2010	5.50	5.5	-	-
	South Bohemia		3.80	3.8
Bitter and Hulec[45], 1980	Czech Republic, North Bohemia	1968-1978	-	1.3	-	17.6
Nedbal et al[46], 1967	Czech Republic	1960-1965	-	1.4	-	10.7
Salupere[47], 2001	Estonia, Tartu County	1993-1998	1.40	1.7	-	-
Kull et al[48], 1998	Estonia, Tartu County	1973-1992	0.27	1.5	-	-
Burisch et al[8], 20141	Estonia, Southern Estonia	2010	5.20	5.2	-	-
Nagy et al[49], 2004	Hungary, Borsod-Abaúj-Zemplén County	1962-1992	-	1.4	-	10.4
Lakatos et al[10], 2011	Hungary, Western Hungary	2002-2006	8.87	11.9	115.3	211.1
Lakatos et al[9], 2004	Hungary, Veszprém County	I: 1997-2001	2.23	5.89	52.9	142.6
		P: 1991-2001
Burisch et al[8], 20141	Hungary, Veszprém County	2010	11.5	10.3	-	-
Zvirbliene et al[50], 20032	Lithuania	1995-2001	-	-	10.0	30-40
Kiudelis et al[51], 2012	Lithuania, Kaunas	2007-2009	1.21	6.56	-	-
Burisch et al[8], 20141	Lithuania, Kaunas	2010	2.40	6.1	-	-
Chojecki[52], 1964	Poland, Warsaw	1951-1960	0.66	-	66.0	-
Wiercinska-Drapalo et al[53], 2005	Poland, Bialystok	1990-2003	0.10	1.8	-	-
Gheorghe et al[54], 1997	Romania, Bucharest	1990-1997	0.42	-	-	-
Gheorghe et al[11], 2004	Romania, nationwide	I: 2002-2003	0.50	0.97	1.51	2.42
		P: 2004
Toader[55], 2008	Romania, North-East region	1988-2007	1.54	0.35	-	-
Burisch et al[8], 20141	Romania, Timis	2010	1.70	2.4	-	-
Príkazská et al[56], 1996	Slovakia, nationwide	1994	6.75	-	-	-
Príkazka et al[57], 1998	Slovakia, nationwide	1994	-	-	6.75	-
Gregus et al[12], 2014	Slovakia	2013	4.60	6.8	80.5	150.5

¹Aged ≥ 15 years;

²Extrapolation by Lakatos et al[7], 2006. I: Incidence; P: Prevalence; CD: Crohn's disease; UC: Ulcerative colitis.

Table 2 Estimated number of newly diagnosed and prevalent Crohn's disease and ulcerative colitis patients aged ≥ 15 years in 9 selected Central and Eastern European countries, 2013

	Number of new patients			Total patient number
	CD	UC	Total	CD	UC	Total
Bulgaria	208	290	497	6162	11381	17543
Czech Republic	416	416	833	8768	16192	24960
Estonia	58	58	116	1090	2013	3103
Hungary	975	873	1848	9775	17897	27672
Latvia	57	80	137	1695	3131	4826
Lithuania	61	155	216	2482	4584	7066
Poland	1080	1506	2586	32049	59188	91237
Romania	287	405	692	16526	30520	47046
Slovakia	211	311	522	3687	6893	10580
Total	3353	4094	7447	82235	151798	234033

Data sources: Numbers of new patients were estimated based on incidence data by Burisch et al[8], 2014. In case of the Czech Republic mean of two available regional incidence data was calculated (4.65/10⁵ both for CD and UC), and for Bulgaria and Lithuania mean incidence rate of 8 CEE countries (Croatia, Czech Republic, Estonia, Hungary, Lithuania, Moldova, Romania, and Russia) calculated by Burisch et al[8] was applied (CD 3.3/10⁵, UC 4.6/10⁵). Total patient number was estimated using data from Gregus et al[12], 2014 for Slovakia (CD 80.5/10⁵, UC 150.5/10⁵) and Lakatos et al[10], 2011 for Hungary (CD 115.3/10⁵, UC 211.1/10⁵). For the other countries mean prevalence rates of Slovakia and Hungary were applied (CD 97.9/10⁵, UC 180.8/10⁵). Population data were obtained from Eurostat Statistics Database[34]. CD: Crohn's disease; UC: Ulcerative colitis.

Table 3 Number of Crohn's disease and ulcerative colitis patients treated with biologicals and centres where biologicals are administered in 9 selected Central and Eastern European countries, 2014

Country	Number of patients								Centres
	CD1			UC1				Total
	Infliximab	Adalimumab	Total	Infliximab	Adalimumab	Golimumab	Total
Bulgaria	NR	46	46	NR	0	NR	0	46	4
Czech Republic	750	240	990	412	NA	NA	412	1402	26
Estonia	29	13	42	21	5	1	27	69	4
Hungary	970	900	1870	460	170	0	630	2500	16
Latvia	1	2	3	0	0	0	0	3	1
Lithuania	30	43	73	15	31	0	46	119	4
Poland	506	382	888	NA	NA	NA	NA	888	502
Romania	114	139	253	73	540	37	650	903	7
Slovakia	350	340	690	320	110	10	440	1130	133
Total	2750	2105	4855	1301	856	48	2205	7060	125

¹Including paediatric and adult patients;

²Approximately;

³10 adult and 3 paediatric. National gastroenterology societies, ministries of health, IMS data, personal communication. NA: Not available; NR: Not reimbursed; CD: Crohn's disease; UC: Ulcerative colitis.