Initial Insights from the EULAR RheumaFacts Initiative

Rheumatic and musculoskeletal diseases (RMDs) stand as the foremost contributors to disability on a global scale, incurring significant healthcare and social support expenses. A key factor in this growing challenge appears to be the inconsistency in resource allocation across Europe, coupled with the organizational dynamics of healthcare systems that give rise to disparities and health inequities among nations.

At the 2025 congress of EULAR--The European Alliance of Associations for Rheumatology--held in Barcelona, new findings were presented regarding health-related indicators for RMDs, gathered as part of the RheumaFacts project. This research aims to identify potential inequities between various countries. Data encompassing a wide array of subjects, such as access to reimbursed physiotherapy and psychological services, the ability of patients to directly consult rheumatologists in the public sector, the number of rheumatology departments, and the availability of treatments were collected. To date, information from 31 countries has been compiled.

The results indicated that the density of rheumatology departments per 100,000 residents varied significantly, ranging from 0.02 to 0.9, with the majority (70%) located in non-academic facilities. The number of rheumatologists per 100,000 residents exhibited an even wider disparity, falling between 0.6 and 8.27. The provision of care to pediatric patients by rheumatologists was particularly inconsistent, with figures ranging from 4 to 84. Furthermore, only 17 countries allow self-referral to rheumatologists within the public healthcare sector.

Regarding treatment accessibility, most countries (93%) reported having access to all available conventional systemic disease-modifying antirheumatic drugs (csDMARDs). However, only 37% and 47% had access to all biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), respectively. Nonetheless, nearly all countries, except one, had at least one bDMARD accessible, primarily tumor necrosis factor inhibitors (TNFi).

Access to physiotherapy for RMD patients on a chronic care basis was reported by only 63% of the countries surveyed, and a mere 30% indicated availability of psychological care.

During the congress presentation, the lead researcher highlighted that there is considerable variability across Europe, with approximately half of the countries lacking comprehensive access to medications and reimbursed non-pharmacological treatments. The RheumaFacts initiative is expected to facilitate monitoring of these disparities, with the hope that inequities will diminish, ultimately enhancing the health outcomes for individuals living with RMDs.

For further details, refer to the study presented at EULAR 2025, which emphasizes the urgent need for addressing health inequities in the treatment of rheumatic and musculoskeletal diseases.