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Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysis

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Abstract

To compare healthcare resource utilization and costs between ankylosing spondylitis (AS) patients and a matched sample from the general population without AS covered by the German Statutory Health Insurance (SHI) system, a non-interventional retrospectively matched cohort analysis was conducted using anonymized SHI claims data. Data from January 1st, 2011 through December 31st, 2014 were analyzed. Individuals with a coded diagnosis of AS during the enrollment period comprising the full year of 2013 were directly matched (1:5) to individuals without AS diagnosis in the whole study period by age, gender, hospitalizations, and comorbidities. All-cause healthcare resource utilization and direct costs were analyzed for the year 2013. Statistical tests were applied to compare the differences between the two sampled populations. In 2013, 10,208 AS patients were identified and matched to a sample of 51,040 patients without AS from the general population. Healthcare resource utilization was significantly higher in all healthcare sectors (inpatient, outpatient, pharmaceuticals, remedies, devices and aids, and sick leave) in the AS cohort. Mean all-cause healthcare costs per patient were about €2475 higher in the AS cohort compared to the general population. Most important cost drivers were hospitalizations and pharmaceuticals in terms of bDMARDs prescribed in 10% of the patients. Real-world data from this German claims database analysis showed that AS is associated with a substantial incremental economic burden to the healthcare system.

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Author information

Authors and Affiliations

  1. Praxiszentrum, St.-Bonifatius-Straße 5, 81541, Munich, Germany

    Klaus Krüger

  2. Rheumapraxis Hildesheim, Bahnhofsplatz 5, 31134, Hildesheim, Germany

    Ulrich von Hinüber

  3. Wilhelm Loehe University of Applied Sciences (WLH), Merkurstraße 41, 90763, Fürth, Germany

    Florian Meier

  4. Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA

    Haijun Tian

  5. Novartis Pharma GmbH, Roonstraße 25, 90429, Nuremberg, Germany

    Katharina Böhm

  6. Novartis Pharma AG, Lichtstraße 35, 4056, Basel, Switzerland

    Steffen M. Jugl

  7. Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany

    Kathrin Borchert, Dominic Meise, Christine König & Sebastian Braun

Authors
  1. Klaus Krüger
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  2. Ulrich von Hinüber
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  3. Florian Meier
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  4. Haijun Tian
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  5. Katharina Böhm
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  6. Steffen M. Jugl
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  7. Kathrin Borchert
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  8. Dominic Meise
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  9. Christine König
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  10. Sebastian Braun
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Corresponding author

Correspondence to Kathrin Borchert.

Appendix

Appendix

Codes used for the identification of comorbidities, manifestations, and AS-related prescriptions

Description

Codes for identification

Comorbidities and manifestations

ICD-10-GM codes

Dactylitis

L08.9

Enthesitis

M76*, M77*

Monoarthritis

M13.1

Polyarthritis

M13.0

Fibromyalgia

M79.7

Sacroiliitis

M46.1

Psoriasis

L40*, L41*

Psoriatic arthritis, overall

M07*

Psoriatic arthritis

M07.0*–M07.3*, M09.0*

Acute anterior uveitis /iridocyclitis

H20.0*

Crohn’s disease

K50*

Ulcerative colitis

K51*

AS-related pharmaceuticals

ATC codes

NSAIDs

M01AA*-C*, M01AE*, M01AG*, M01AH*, N02BA01

Sulfasalazines

M01CX02

bDMARDs

L04AB01-2, L04AB04-6

Glucocorticoids

H02AB*

Opioids

N02A*

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Krüger, K., von Hinüber, U., Meier, F. et al. Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysis. Rheumatol Int 38, 2121–2131 (2018). https://doi.org/10.1007/s00296-018-4124-z

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  • DOI: https://doi.org/10.1007/s00296-018-4124-z

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