{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:12:10Z","timestamp":1782897130043,"version":"3.54.5"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"DOI":"10.13039\/501100004115","name":"Gottfried Wilhelm Leibniz Universit\u00e4t Hannover","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004115","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Z Rheumatol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Durch den fach\u00e4rztlichen Versorgungsmangel in der Rheumatologie in Deutschland kommt es f\u00fcr betroffene Patienten h\u00e4ufig zu einer verz\u00f6gerten Diagnosestellung, was eine fr\u00fchzeitige und effektive Behandlung verhindert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit<\/jats:title>\n                    <jats:p>Die Studie untersucht die Auswirkungen von fr\u00fchem vs. sp\u00e4tem Facharztzugang auf die Arzneimittelverordnungen und -kosten.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Kostenanalyse im Rahmen der Deliver-Care-Studie mittels GKV-Routinedaten f\u00fcr die Jahre 2015\u20132020. Patienten mit gesicherter rheumatoider Arthritis (ICD-10 M05\/M06) wurden nach dem Zeitpunkt ihres ersten Facharztkontakts gruppiert: fr\u00fcher Zugang (im Diagnosequartal, Q1) vs. sp\u00e4ter Zugang (Q2\u2013Q4). F\u00fcr die beiden Gruppen wurden die Arzneimittelkosten verglichen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>\n                      Mehr als die H\u00e4lfte (57,4\u202f%) der M05- und ca. ein Viertel (24,4\u202f%) der M06-Patienten hatten gar keinen Facharztzugang im ersten Jahr nach Stellung der Verdachtsdiagnose. Von den Patienten mit Facharztkontakt (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u20093781 Patienten) hatten 82,7\u202f% einen fr\u00fchen Facharztzugang. Patienten mit sp\u00e4terem Facharztzugang wiesen h\u00f6here Medikationskosten auf (4343\u202f\u20ac in Q4 vs. 1763\u202f\u20ac in Q1;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090,0001). Eine Sensitivit\u00e4tsanalyse zeigte, dass Patienten mit sp\u00e4tem Facharztzugang fr\u00fcher auf hochpreisige Medikamente umgestellt wurden als Patienten mit fr\u00fchem Zugang.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diskussion<\/jats:title>\n                    <jats:p>Ein fr\u00fcher Facharztzugang f\u00fchrt zu einer geringeren Verordnungsh\u00e4ufigkeit von Biologika und niedrigeren Arzneimittelkosten. Die Ergebnisse zeigen, dass eine fr\u00fchzeitige Diagnose und Therapie langfristig nicht nur die Krankheitslast der Patienten reduziert, sondern auch Kosteneinsparungen bei der Behandlung von Patienten mit rheumatoider Arthritis erm\u00f6glicht.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00393-026-01785-6","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:55:14Z","timestamp":1770281714000},"page":"272-279","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Der Preis des sp\u00e4ten Facharztzugangs\u00a0\u2013 Auswirkungen auf die Arzneimittelkosten bei rheumatoider Arthritis","Consequences of late access to specialist care\u2014effect on medication costs in rheumatoid arthritis"],"prefix":"10.1007","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9003-2656","authenticated-orcid":false,"given":"Luisa V.","family":"Licker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Pardey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3914-0575","authenticated-orcid":false,"given":"Kristine","family":"Kreis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jona T.","family":"Stahmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Zinke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Meyer-Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-0267","authenticated-orcid":false,"given":"Torsten","family":"Witte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4327-9836","authenticated-orcid":false,"given":"Kirsten","family":"Hoeper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-2267","authenticated-orcid":false,"given":"Jan","family":"Zeidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"1785_CR1","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/s00393-022-01305-2","volume":"82","author":"K Albrecht","year":"2023","unstructured":"Albrecht\u00a0K, Binder\u00a0S, Minden\u00a0K et\u00a0al (2023) Systematisches Review zur Sch\u00e4tzung der Pr\u00e4valenz entz\u00fcndlich rheumatischer Erkrankungen in Deutschland. 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T.\u00a0Witte hat Vortragshonorare von AbbVie, Medac, Pfizer, Lilly, J&J, Novartis und UCB erhalten. K.\u00a0Hoeper hat Honorare f\u00fcr Beratert\u00e4tigkeiten, Vortr\u00e4ge und\/oder wissenschaftliche T\u00e4tigkeiten von AbbVie, Chugai und Galapagos erhalten.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Die Studie wurde von der Ethikkommission der Medizinischen Hochschule Hannover genehmigt (Referenz-Nr. 9027_BO_S_2020) und im Verlauf von den jeweiligen zust\u00e4ndigen Ethikkommissionen der Bundesl\u00e4nder der teilnehmenden Zentren. Zudem wurde die im Deutschen Register Klinische Studien (DRKS) unter der Nummer DRKS00023000 registriert.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}