{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T06:03:01Z","timestamp":1772258581836,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,11]],"date-time":"2021-09-11T00:00:00Z","timestamp":1631318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Real-world data indicate disparities in biologic access across Europe. Objectives: To describe the national structure of PsA care in Poland, with a particular focus on the population of inadequate responders (IRs) and difficulties associated with biologic therapy access. Methods: A pool of rheumatologic and dermatologic care centers was created based on National Health Fund contract lists (n = 841), from which 29 rheumatologic and 10 dermatologic centers were sampled randomly and successfully met the inclusion criterium. Additionally, 33 tertiary care centers were recruited. For successful center recruitment, one provider had to recruit at least one patient that met the criteria for one of the four pre-defined clinical subgroups, in which all patients had to have active PsA and IR status to at least 2 conventional synthetic disease-modifying drugs (csDMARDs). Self-assessment questionnaires were distributed among physicians and their patients. Results: Barriers to biologic DMARD (bDMARD) treatment are complex and include stringency of reimbursement criteria, health care system, logistic\/organizational, and personal choice factors. For patients who are currently bDMARD users, the median waiting time from the visit, at which the reimbursement procedure was initiated, to the first day of bDMARD admission was 9 weeks (range 2\u2013212; 32% &lt; 4 weeks, 29% 5\u201312 weeks, 26% 13\u201328 weeks, 13% with &gt;28 weeks delay). Out of all inadequate responder groups, bDMARD users are the only group with \u201cgood\u201d therapeutic situation and satisfaction with therapy. Patient satisfaction with therapy is not always concordant with physician assessment of therapeutic status. Conclusions: Despite the fact that over a decade has passed since the introduction of biologic agents, in medium welfare countries such as Poland, considerable healthcare system barriers to biologic access are present. Out of different IR populations, patient satisfaction with treatment is often discordant with physician assessment of disease status.<\/jats:p>","DOI":"10.3390\/jcm10184106","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T21:45:57Z","timestamp":1631483157000},"page":"4106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-World Data from a Multi-Center Study: Insights to Psoriatic Arthritis Care"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-8093","authenticated-orcid":false,"given":"Bogdan","family":"Batko","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University, 30-705 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugeniusz","family":"Kucharz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Stajszczyk","sequence":"additional","affiliation":[{"name":"Silesian Rheumatology Center, Rheumatology and Autoimmune Diseases Department, 43-450 Ustron, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Brzosko","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Internal Diseases, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W\u0142odzimierz","family":"Samborski","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zbigniew","family":"\u017buber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland"},{"name":"Ward for Older Children with Neurology and Rheumatology Subdivision, St. Louis Regional Specialised Children\u2019s Hospital, 31-503 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,11]]},"reference":[{"key":"ref_1","first-page":"680","article-title":"The Burden of Psoriatic Arthritis: A Literature Review from a Global Health Systems Perspective","volume":"35","author":"Lee","year":"2010","journal-title":"Pharm. 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