<?xml version="1.0" encoding="UTF-8"?><mets:mets xmlns:mets="http://www.loc.gov/METS/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" xmlns:mads="http://www.loc.gov/mads/" xmlns:metsRights="http://cosimo.stanford.edu/sdr/metsrights/" xmlns:suj="http://www.theses.fr/namespace/sujets" xmlns:tef="http://www.abes.fr/abes/documents/tef" xmlns:tefextension="http://www.abes.fr/abes/documents/tefextension" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/METS/ http://www.abes.fr/abes/documents/tef/recommandation/tef_schemas.xsd">
<mets:metsHdr CREATEDATE="2017-09-19T11:16:03" ID="ABES.STAR.THESE_94046.METS_HEADER" LASTMODDATE="2024-05-26T04:01:43Z" RECORDSTATUS="valide">
<mets:agent ROLE="CREATOR">
<mets:name/>
<mets:note>Note</mets:note>
</mets:agent>
<mets:agent ROLE="DISSEMINATOR">
<mets:name>ABES</mets:name>
</mets:agent>
<mets:altRecordID ID="ABES.STAR.THESE_94046.METS_HEADER.ALTERNATE" TYPE=""/>
</mets:metsHdr>
<mets:dmdSec ID="ABES.STAR.THESE_94046.DESCRIPTION_BIBLIOGRAPHIQUE">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_desc_these">
<mets:xmlData>
<tef:thesisRecord>
<dc:title xml:lang="fr">Stratégies de prise en charge de la polyarthrite rhumatoïde : quelle place pour les médicaments biosimilaires ?</dc:title>
<dcterms:alternative xml:lang="en">Strategies for the treatment of rheumatoid arthritis : what is the place of biosimilar drugs ?</dcterms:alternative>
<dc:subject xml:lang="fr">Médicaments biosimilaires</dc:subject>
<dc:subject xml:lang="fr">Polyarthrite rhumatoïde</dc:subject>
<dc:subject xml:lang="fr">Économies</dc:subject>
<dc:subject xml:lang="fr">Enquête</dc:subject>
<dc:subject xml:lang="fr">Bases de données médico-administratives</dc:subject>
<dc:subject xml:lang="en">Biosimilar drugs</dc:subject>
<dc:subject xml:lang="en">Rheumatoid arthritis</dc:subject>
<dc:subject xml:lang="en">Cost savings</dc:subject>
<dc:subject xml:lang="en">Survey</dc:subject>
<dc:subject xml:lang="en">, health insurance claims databases</dc:subject>
<dc:subject xsi:type="dcterms:DDC">615.5</dc:subject>
<dc:subject xsi:type="dcterms:DDC">616.7</dc:subject>
<tef:sujetRameau xml:lang="fr">
<tef:vedetteRameauNomCommun>
<tef:elementdEntree autoriteExterne="027389898" autoriteSource="Sudoc">Polyarthrite rhumatoïde</tef:elementdEntree>
<tef:subdivision autoriteExterne="027589838" autoriteSource="Sudoc" type="subdivisionDeSujet">Thérapeutique</tef:subdivision>
</tef:vedetteRameauNomCommun>
<tef:vedetteRameauNomCommun>
<tef:elementdEntree autoriteExterne="147069289" autoriteSource="Sudoc">Biosimilaires</tef:elementdEntree>
</tef:vedetteRameauNomCommun>
<tef:vedetteRameauNomCommun>
<tef:elementdEntree autoriteExterne="050363654" autoriteSource="Sudoc">Pharmacoéconomie</tef:elementdEntree>
</tef:vedetteRameauNomCommun>
</tef:sujetRameau>
<dcterms:abstract xml:lang="fr">Le coût des biomédicaments impacte lourdement le fardeau financier déjà important imposé par la polyarthrite rhumatoïde (PR) à la société. Le but de ce travail était de rechercher les motivations de la prescription des médicaments biosimilaires en rhumatologie, tout particulièrement pour prendre en charge les patients atteints de PR. Les travaux effectués ont permis d’estimer les économies annuelles réalisables en France avec le médicament biosimilaire de l’infliximab à 13,6 millions d’EUR, pour la seule prise en charge de la PR. Par ailleurs, une enquête menée auprès des rhumatologues et pharmaciens a permis d’identifier les principaux enjeux liés à l’utilisation de ces médicaments. Enfin, le suivi de leur utilisation en région Grand Est entre 2015 et 2016 rend compte de leur utilisation encore modeste. La mise sur le marché régulière de médicaments biosimilaires, combinée à l’expérience croissante des acteurs et aux dispositifs d’incitation mis en place, devraient permettre de faire progresser la part d’utilisation de ces médicaments dans les prochaines années, et de s’assurer qu’ils tiennent bien leurs engagements sur le plan des économies réalisées.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Biological drugs are associated with high procurement costs and heavily impact the financial burden imposed by rheumatoid arthritis on society. The purpose of this work was to investigate the benefits of using biosimilar drugs in rheumatoid arthritis patients. This work showed the introduction of biosimilar inﬂiximab could lead to substantial annual cost savings of up to €13.6 million nationally, to treat rheumatoid arthritis patients only. Moreover, a biosimilar survey involving rheumatologists and pharmacists allowed us to identify the main issues at stake. Finally, the monitoring of their use in Grand Est region between 2015 and 2016 account for their relatively low utilization rate. The regular launch of new biosimilar medicines, together with growing experience of healthcare players and incentive policies, should allow to increase biosimilar uptake in the future, and also to make sure they meet well their commitments in terms of savings generated.</dcterms:abstract>
<dc:type>Electronic Thesis or Dissertation</dc:type>
<dc:type xsi:type="dcterms:DCMIType">Text</dc:type>
<dc:language xsi:type="dcterms:RFC3066">fr</dc:language>
</tef:thesisRecord>
</mets:xmlData>
</mets:mdWrap>
</mets:dmdSec>
<mets:dmdSec ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DESCRIPTION.EDITION_ARCHIVAGE">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_desc_edition">
<mets:xmlData>
<tef:edition>
<dcterms:medium xsi:type="dcterms:IMT">PDF</dcterms:medium>
<dcterms:extent>95557437</dcterms:extent>
<tef:editeur>
<tef:nom>Université de Strasbourg</tef:nom>
<tef:place>Strasbourg</tef:place>
</tef:editeur>
<dcterms:issued xsi:type="dcterms:W3CDTF">2018-12-31</dcterms:issued>
<dc:identifier xsi:type="dcterms:URI">https://theses.hal.science/tel-01715097</dc:identifier>
</tef:edition>
</mets:xmlData>
</mets:mdWrap>
</mets:dmdSec>
<mets:dmdSec ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DESCRIPTION.EDITION_1">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_desc_edition">
<mets:xmlData>
<tef:edition>
<dcterms:medium xsi:type="dcterms:IMT">application/pdf</dcterms:medium>
<dcterms:extent>37170260</dcterms:extent>
<dc:identifier xsi:type="dcterms:URI">https://publication-theses.unistra.fr/public/theses_doctorat/2017/Beck_Morgane_2017_ed414.pdf</dc:identifier>
<dc:identifier xsi:type="dcterms:URI">http://www.theses.fr/2017STRAJ039/abes</dc:identifier>
<dc:identifier xsi:type="dcterms:URI"/>
<dc:identifier xsi:type="dcterms:URI">https://theses.hal.science/tel-01715097</dc:identifier>
<dc:identifier xsi:type="dcterms:URI">https://theses.hal.science/tel-01715097</dc:identifier>
<dc:identifier xsi:type="dcterms:URI">https://theses.hal.science/tel-01715097</dc:identifier>
</tef:edition>
</mets:xmlData>
</mets:mdWrap>
</mets:dmdSec>
<mets:amdSec>
<mets:techMD ID="ABES.STAR.THESE_94046.ADMINISTRATION">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_admin_these">
<mets:xmlData>
<tef:thesisAdmin>
<tef:auteur>
<tef:nom>Beck</tef:nom>
<tef:prenom>Morgane</tef:prenom>
<tef:dateNaissance>1988-03-06</tef:dateNaissance>
<tef:nationalite scheme="ISO-3166-1">FR</tef:nationalite>
<tef:autoriteExterne autoriteSource="Sudoc">190550422</tef:autoriteExterne>
<tef:autoriteExterne autoriteSource="CODE_ETUDIANT">40604225</tef:autoriteExterne>
</tef:auteur>
<dc:identifier xsi:type="tef:nationalThesisPID">https://theses.fr/2017STRAJ039</dc:identifier>
<dc:identifier xsi:type="tef:NNT">2017STRAJ039</dc:identifier>
<dc:identifier xsi:type="tef:DOI">https://doi.org/10.70675/21ecbeabzc9f5z4b09za867z979d58515a81</dc:identifier>
<dcterms:dateAccepted xsi:type="dcterms:W3CDTF">2017-09-05</dcterms:dateAccepted>
<tef:thesis.degree>
<tef:thesis.degree.discipline xml:lang="fr">Santé publique</tef:thesis.degree.discipline>
<tef:thesis.degree.grantor>
<tef:nom>Strasbourg</tef:nom>
<tef:autoriteExterne autoriteSource="Sudoc">131056549</tef:autoriteExterne>
</tef:thesis.degree.grantor>
<tef:thesis.degree.level>Doctorat</tef:thesis.degree.level>
<tef:thesis.degree.name xml:lang="fr">Docteur es</tef:thesis.degree.name>
</tef:thesis.degree>
<tef:theseSurTravaux>non</tef:theseSurTravaux>
<tef:avisJury>oui</tef:avisJury>
<tef:directeurThese>
<tef:nom>Velten</tef:nom>
<tef:prenom>Michel</tef:prenom>
<tef:autoriteInterne>MADS_DIRECTEUR_DE_THESE_1</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">061540536</tef:autoriteExterne>
</tef:directeurThese>
<tef:directeurThese>
<tef:nom>Sibilia</tef:nom>
<tef:prenom>Jean</tef:prenom>
<tef:autoriteInterne>MADS_DIRECTEUR_DE_THESE_2</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">067331270</tef:autoriteExterne>
</tef:directeurThese>
<tef:presidentJury>
<tef:nom>Guenot</tef:nom>
<tef:prenom>Dominique</tef:prenom>
<tef:autoriteInterne>MADS_PRESIDENT_DU_JURY</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">072650966</tef:autoriteExterne>
</tef:presidentJury>
<tef:membreJury>
<tef:nom>Debeuret</tef:nom>
<tef:prenom>Christine</tef:prenom>
<tef:autoriteInterne>MADS_MEMBRE_DU_JURY_1</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">084997117</tef:autoriteExterne>
</tef:membreJury>
<tef:rapporteur>
<tef:nom>Fautrel</tef:nom>
<tef:prenom>Bruno</tef:prenom>
<tef:autoriteInterne>MADS_RAPPORTEUR_1</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">061407364</tef:autoriteExterne>
</tef:rapporteur>
<tef:rapporteur>
<tef:nom>Demoré</tef:nom>
<tef:prenom>Béatrice</tef:prenom>
<tef:autoriteInterne>MADS_RAPPORTEUR_2</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">076944409</tef:autoriteExterne>
</tef:rapporteur>
<tef:ecoleDoctorale>
<tef:nom>École doctorale des Sciences de la vie et de la santé (Strasbourg ; 2000-....)</tef:nom>
<tef:autoriteInterne>MADS_ECOLE_DOCTORALE_1</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Annuaire des formations doctorales et des unités de recherche">VS</tef:autoriteExterne>
<tef:autoriteExterne autoriteSource="Sudoc">156502844</tef:autoriteExterne>
</tef:ecoleDoctorale>
<tef:partenaireRecherche type="laboratoire">
<tef:nom>Progression tumorale et micro-environnement. Approches translationnelles et épidémiologie (Strasbourg)</tef:nom>
<tef:autoriteInterne>MADS_PARTENAIRE_DE_RECHERCHE_1</tef:autoriteInterne>
<tef:autoriteExterne autoriteSource="Sudoc">176973990</tef:autoriteExterne>
<tef:autoriteExterne autoriteSource="labTEL">245026</tef:autoriteExterne>
</tef:partenaireRecherche>
<tef:oaiSetSpec>ddc:610</tef:oaiSetSpec>
<tef:MADSAuthority authorityID="MADS_DIRECTEUR_DE_THESE_1" type="personal">
<tef:personMADS>
<mads:namePart type="family">Velten</mads:namePart>
<mads:namePart type="given">Michel</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_DIRECTEUR_DE_THESE_2" type="personal">
<tef:personMADS>
<mads:namePart type="family">Sibilia</mads:namePart>
<mads:namePart type="given">Jean</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_PRESIDENT_DU_JURY" type="personal">
<tef:personMADS>
<mads:namePart type="family">Guenot</mads:namePart>
<mads:namePart type="given">Dominique</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_MEMBRE_DU_JURY_1" type="personal">
<tef:personMADS>
<mads:namePart type="family">Debeuret</mads:namePart>
<mads:namePart type="given">Christine</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_RAPPORTEUR_1" type="personal">
<tef:personMADS>
<mads:namePart type="family">Fautrel</mads:namePart>
<mads:namePart type="given">Bruno</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_RAPPORTEUR_2" type="personal">
<tef:personMADS>
<mads:namePart type="family">Demoré</mads:namePart>
<mads:namePart type="given">Béatrice</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_ECOLE_DOCTORALE_1" type="corporate">
<tef:personMADS>
<mads:namePart type="family">École doctorale Sciences de la vie et de la santé (Strasbourg)</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
<tef:MADSAuthority authorityID="MADS_PARTENAIRE_DE_RECHERCHE_1" type="corporate">
<tef:personMADS>
<mads:namePart type="family">Progression tumorale et micro-environnement. Approches translationnelles et épidémiologie (Strasbourg)</mads:namePart>
</tef:personMADS>
</tef:MADSAuthority>
</tef:thesisAdmin>
</mets:xmlData>
</mets:mdWrap>
</mets:techMD>
<mets:techMD ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE.TECH_FICHIER.DOSSIER_1.DOSSIER_1.FICHIER_1">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_tech_fichier">
<mets:xmlData>
<tef:meta_fichier>
<tef:formatFichier>PDF</tef:formatFichier>
<tef:taille>95557437</tef:taille>
</tef:meta_fichier>
</mets:xmlData>
</mets:mdWrap>
</mets:techMD>
<mets:rightsMD ID="ABES.STAR.THESE_94046.DROITS_UNIVERSITE">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_etablissement_these">
<mets:xmlData>
<metsRights:RightsDeclarationMD RIGHTSCATEGORY="CONTRACTUAL">
<metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
<metsRights:Context CONTEXTCLASS="INSTITUTIONAL AFFILIATE">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
</metsRights:RightsDeclarationMD>
</mets:xmlData>
</mets:mdWrap>
</mets:rightsMD>
<mets:rightsMD ID="ABES.STAR.THESE_94046.DROITS_DOCTORANT">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_auteur_these">
<mets:xmlData>
<metsRights:RightsDeclarationMD RIGHTSCATEGORY="CONTRACTUAL">
<metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
<metsRights:Context CONTEXTCLASS="INSTITUTIONAL AFFILIATE">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
</metsRights:RightsDeclarationMD>
</mets:xmlData>
</mets:mdWrap>
</mets:rightsMD>
<mets:rightsMD ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DROITS">
<mets:mdWrap MDTYPE="OTHER" OTHERMDTYPE="tef_droits_version">
<mets:xmlData>
<metsRights:RightsDeclarationMD RIGHTSCATEGORY="CONTRACTUAL">
<metsRights:Context CONTEXTCLASS="GENERAL PUBLIC">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
<metsRights:Context CONTEXTCLASS="INSTITUTIONAL AFFILIATE">
<metsRights:Permissions COPY="false" DELETE="false" DISPLAY="true" DUPLICATE="true" MODIFY="false" PRINT="false"/>
</metsRights:Context>
</metsRights:RightsDeclarationMD>
</mets:xmlData>
</mets:mdWrap>
</mets:rightsMD>
</mets:amdSec>
<mets:fileSec>
<mets:fileGrp ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE.FILEGRP" USE="archive">
<mets:file ADMID="ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE.TECH_FICHIER.DOSSIER_1.DOSSIER_1.FICHIER_1" ID="ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE.DOSSIER_1.DOSSIER_1.FICHIER_1" SEQ="1">
<mets:FLocat LOCTYPE="URL" xlink:href="STRA/THESE_94046/document/0/0/BECK_Morgane_2017_ED414_A.pdf"/>
</mets:file>
</mets:fileGrp>
</mets:fileSec>
<mets:structMap TYPE="logical">
<mets:div ADMID="ABES.STAR.THESE_94046.ADMINISTRATION ABES.STAR.THESE_94046.DROITS_UNIVERSITE ABES.STAR.THESE_94046.DROITS_DOCTORANT" CONTENTIDS="CONTENTIDS.ABES.STAR.THESE_94046" DMDID="ABES.STAR.THESE_94046.DESCRIPTION_BIBLIOGRAPHIQUE" TYPE="THESE">
<mets:div ADMID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DROITS" CONTENTIDS="CONTENTIDS.ABES.STAR.THESE_94046.ABES.STAR.THESE_94046.VERSION_COMPLETE" TYPE="VERSION_COMPLETE">
<mets:div CONTENTIDS="CONTENTIDS.ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE" DMDID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DESCRIPTION.EDITION_ARCHIVAGE" TYPE="EDITION">
<mets:fptr FILEID="ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_ARCHIVAGE.FILEGRP"/>
</mets:div>
<mets:div CONTENTIDS="CONTENTIDS.ABES.STAR.THESE_94046.VERSION_COMPLETE.EDITION_1" DMDID="ABES.STAR.THESE_94046.VERSION_COMPLETE.DESCRIPTION.EDITION_1" TYPE="EDITION"/>
</mets:div>
</mets:div>
</mets:structMap>
</mets:mets>