Artikel
Association between private health insurance coverage and the prevalence of biological therapy in patients with rheumatic diseases
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Autoren
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Karel Kostev
- IQVIA, Epidemiology, Frankfurt am Main
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Susanne van der Beck
- IQVIA, Frankfurt am Main
| Veröffentlicht: | 8. Oktober 2019 |
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Gliederung
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Background: Today, biologics are often used to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS). They can be can be very effective but are also very expensive. In this study, we aimed to analyze the impact of health insurance status on the incidence of biological therapy in RA and AS patients in Germany.
Methods: All data were drawn from the IMS® Disease Analyzer database, which provides access to a representative panel of German physicians and patients. The data is anonymized and processed in accordance with German data safety regulations. For this study, data were taken from 21 office-based rheumatologists who provided IQVIA with their patient data, including diagnoses, prescriptions, and demographic information from 2010 until 2018. The date of the first RA or AS diagnosis became the index date. The primary outcome was defined as initiation of biological therapy within five years after the index date. Incidence of biological therapy was calculated using Kaplan-Meier curves. The association between insurance status (private versus statutory health insurance coverage) and biological therapy incidence was estimated using a Cox regression model adjusted for age, sex, and initial diagnosis (RA, AS).
Results: We identified 20,473 patients with RA (mean age: 59 years) and 2,122 patients with AS (mean age: 46 years). Within five years after the index date, 14% of TA and 31% of AS patients received an initial biological prescription. No association was observed between private insurance coverage and biological therapy initiation in AS (odds ratio; OR: 1.12, p=0.64) and young (<50 years) RA (OR: 1.10, p=0.61) patients. However, in older RA age groups, private insurance was significantly associated with the incidence of biological therapy (51-60 years; OR:1.42, p= 0.043; 61-70 years; OR: 1.93, p<0.001; >70 years; OR=2.21, p<0.001).
Conclusion: In RA patients over the age of 50, we found a positive association between private health insurance coverage and biological therapy. Further questionnaire-based research is needed to explore this association.
