Most national guidelines are still far removed from the goals‐based approach recommended by EULAR. This is, of course, largely because they are at present unable to take into account anything but the direct treatment costs of the disease, rather than its wider health system and economic consequences. In the current economic environment the wider impacts of ill‐health are particular important. Finding ways to ensure that health systems can support productivity and target avoidable disability whilst maintaining their own financial sustainability will be at the heart of the health policy debate. The effective treatment of RA with the goal of the rapid achievement of remission or low disease activity is a particular case for careful consideration by policymakers.
This paper draws on a review of existing literature on Rheumatoid Arthritis in Europe and variations in clinical guidelines for its treatment, and compares current guidelines across 12 Member States of the European Union. It finds significant differences affecting patients’ access to the biological agents that have transformed the treatment of RA since the 1990s. The authors compare national guidelines against the consensus recommendations from the European League Against Rheumatism (EULAR).