DOI: 10.5176/2251-3833_GHC17.54
Authors: David Matusiewicz, Julia Ventzke, Wiebke Sondermann, Andreas Körber
Abstract: Backround: Psoriatic arthritis (PsA) is an inflammatory joint disease classified as a spondylarthropathy. Despite of various surveys analyzing medical care of PsA patients in Germany, there is only low evidence regarding pharmaceutical supply of these patients. This is why the present study analyses this thematic focus. Patients and methods: Based on systematic literature research and on administrative data from the health insurace “Allgemeine Ortskrankenkasse“ (AOK), - a regional health insurance with more than 2.8 million insured persons- the present study provides an up-to-date overview of the pharmaceutical supply of PsA patients. Patients were selected when they were diagnosed with a psoriasis arthropathy (L40.5x) according to the International Classification of Diseases (ICD-10-GM version 2015) in the first and second calendar quarter of the year 2014. Data were collected from the in-patient as well as the out-patient sector. Results: Within the first and second calendar quarter of the year 2014 overall 3205 AOK-insured persons were identified having a PsA diagnosis. Gender distribution within the selected population was almost balanced: 1443 patients were male (45{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) and 1762 were female (55{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}). Mean age was 58.9 years (standarddeviation (SD) 13.2 Jahre) on the cutoff date 31.12.2014. Within the analysis period, about 7.2 drugs relevant for PsA therapy per patient were billed. Over time, a mean increase of 3.7{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} was detected. 53.7{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of the PsA patients were treated systemically. NSAIDs (non-steroidal anti-inflammatory drugs) were prescribed by far the most frequently, followed by glucocorticoids. Selected patients receiving a systemic therapy were mainly treated with DMARDs (disease modifying antirheumatic drugs) (especially MTX) in 72.1{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of the cases, followed by a combination of DMARDs andbiologics(20.9{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}). Total annual costs within the selected population of insured people with PsA amounted to 3.591.172,31€ for DMARD therapy in comparison with total annual costs of 28.082.662,89€ for biologic therapy. Knowledge of medical care processes is a crucial prerequisite for future planning of medical supply and allocation decisions.
Keywords: Psoriasis vulgaris, Psoriasis arthritis, research on medical care, medical supply, secondary data, routine data set
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