Article
Resource use and associated costs among patients with rheumatoid arthritis in Germany
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Authors
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Susanne Hartz
- Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Windlesham, UK
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Thorsten Holzkämper
- Lilly Deutschland GmbH, Bad Homburg
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Dimitra Lambrelli
- Evidera, London, UK
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Kristina Karlsdotter
- Evidera, London, UK
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Annabel Barrett
- Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Windlesham
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Thomas Zimmermann
- Lilly Deutschland GmbH, Bad Homburg
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Marie-Ange Paget
- Lilly France, Neuilly-sur-Seine Cedex, France
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Inmaculada de la Torre
- Lilly Spain, Alcobendas, Madrid, Spain
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Raoul Bergner
- Klinikum der Stadt Ludwigshafen, Ludwigshafen
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Ingrid Schubert
- PMV Forschungsgruppe Köln, Köln
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Rebecca Hein
- PMV Forschungsgruppe Köln, Köln
| Published: | September 12, 2014 |
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Outline
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Background: The estimated cost of Rheumatoid arthritis (RA) in Germany exceeded 6 million € in 2008, and represents a significant burden to the healthcare system. Drug management of patients with RA aims to relieve pain and modify the disease evolution, and includes non-steroidal anti-inflammatory drugs (NSAID) or analgesics, glucocorticoids, and conventional disease-modifying antirheumatic drugs (DMARDs). For patients who fail to respond to conventional DMARDs, the initiation of a biologic DMARD is an option.
Objective: To describe resource utilization and cost associated with patients with RA in Germany.
Methods: A retrospective case-control study analyzing data from the Statutory Health Insurance sample AOK Hesse/KV Hesse. Prevalent (2011) and incident (2009 and 2010) patients with an RA diagnosis (ICD-10 codes: M05/M06/M07/M08/M09) were identified and compared to a matched control cohort (1:4, by age/gender/date of death). Analyses were also conducted comparing between patients treated and not treated with biologics.
Results: 3,831 prevalent RA cases were identified (of which 237 were treated with biologics), with 15,324 matched controls. Of the observed total of 818 incident patients (with 3,272 controls), only 19 received biologic therapy.
Resource utilization was higher for both prevalent and incident patients with RA than for controls across the majority of health care services, and in most resources was higher for patients treated with biologics compared to those receiving other therapies. Drug prescriptions were most frequently used, followed by outpatient visits (GP/specialists), medical aids and hospitalizations. The total mean annual cost for the prevalent cases was €7,549 vs. €4,567 for controls. Incident cases accrued similar mean annual costs (€7,038 vs. €4,239 for controls). Key drivers of direct medical costs across all patients were hospitalizations, and drug costs especially for patients treated with biologics. Analyses also revealed that more than half of patients initially diagnosed by a GP did not visit a specialist within one year of follow up.
Conclusion: Analysis of recent data confirms that prescription of biologics is an important contributor to total medical costs. In addition, despite being treated with biologics, these patients do also incur higher resource utilization than patients not treated with biologics, indicating unmet need regarding optimized therapy.
