Barcelona, June 29, 2020
The recent COVID-19 pandemic has increased health inequalities, being the elderly people one of the most affected groups. To date, the response to the pandemic crisis has failed to adequately protect the elderly. As the UN report highlights, the pandemic has demonstrated the need to create stronger legal frameworks at the national and international levels to protect the rights of older people and take them into account in social, economic, and humanitarian responses.”
The lockdown and social distancing measures have produced negative effects on the elderly’s health due to physical inactivity, cognitive deterioration and dementia, fragility, loneliness, or emotional state damage.
Many of these elderly people were also suffering from chronic diseases, one of the most prevalent is osteoarthritis. For them, the most common task can be challenging due to the limitations associated with osteoarthritis and the commonly linked comorbidities such as cardiovascular disease (hypertension, coronary ischemia), liver, kidney, and gastrointestinal diseases, among others.
Nevertheless, in the final phase of the COVID-19 lockdown exit, the Spanish Ministry of Health and Social Welfare continues with the proposal for defunding the SYSADOAs. If such underfunding is applied, it would leave a therapeutic gap for people with osteoarthritis, especially for those with associated comorbidities. For safety reasons, these patients cannot take analgesics, non-steroidal antiinflammatory drugs and opioids chronically due to the well-known adverse effects associated with these drugs categories. The absence of a safe treatment for these patients would lead to a serious worsening of their quality of life and higher healthcare costs.
In Spain, already more than 7 million people suffer from osteoarthritis. It mainly affects elderly people and women. It significantly affects women at younger ages (from 50 years on). Women represent approximately 60% of all osteoarthritis patients (2 out of 3 are women). Also, 80% of women with menopause suffer some joint pain, and of these, 50% recognize it as intense or unbearable. For its prevalence, osteoarthritis can be defined as a gender disease.
The SYSADOAs, especially chondroitin sulfate and its combination with glucosamine are approved and periodically revised by the Spanish Agency for Medicines and Health Products (AEMPS) as proven safe and effective. Also, recent clinical trials and meta-analyses corroborate their efficacy and safety in the treatment of osteoarthritis recommending their use especially in patients with osteoarthritis of the knee and/or hands and in patients with associated comorbidities. These data have also been confirmed by the “Document on the appropriate use of oral SYSADOAs in patients with osteoarthritis in primary care”, an independent report commissioned by the Basic Portfolio of Services of the National Health System and Pharmacy and hand-delivered on September 18, 2019. Also, the same report signed by the experts from the main Spanish medical societies was delivered by e-mail on September 25, 2019.
The definancing of SYSADOAs by the Ministry of Health Social Welfare will affect one of the most vulnerable groups of the population, our elderlies, and especially elderly women, who will have to pay for their only therapeutic option out of pocket. For this reason, we are against this measure and advocate for a health system based on equity and quality, able to protect those most vulnerable and free from any type of discrimination.