PSY78 - THE ECONOMIC AND HEALTHCARE BURDEN OF ANCA-ASSOCIATED VASCULITIS (AAV) IN GERMANY

Abstract

AAV is a rare systemic disease, characterized by recurrent episodes of inflammation. Patients are at risk from acute disease activity, treatment-related toxicities involving high dose glucocorticosteroids (GCs) and cumulative organ damage from both disease and therapy. The economic burden and healthcare resource usage for AAV are currently not well understood. Longitudinal data provided by German insurance (SHI companies) from the InGef database has been analyzed to understand complications associated with steroid therapy for AAV, treatment costs and resource utilization. 79% of AAV patients received ambulant steroids in a 4-year period post AAV diagnosis (Granulomatosis with Polyangiitis (GPA) or Microscopic Polyangiitis (MPA)) with approximately 1/3 developing a serious infection requiring or during hospitalization. Total costs for AAV patients during induction were between €28,137-26,137 for GPA/MPA respectively. Subsequent cumulative costs for induction and three years post treatment ranged from €70,641-94,889. Severe kidney disease (occurred in up to 11-25% of AAV patients in four years post treatment) is a key driver of increasing cumulative patient costs ranging from €131,521-145,472 for GPA/MPA. Approximately 10% of GPA patients and 18% of MPA patient required renal replacement therapy already in the induction period. Over 90% of patients with GPA/MPA were hospitalized during the induction treatment period of which 60% are hospitalized due to an active GPA/MPA diagnosis. In 2013, 66%-76% of prevalent GPA/MPA patients were hospitalized, the majority due to a diagnosis of active GPA/MPA disease with associated co-morbidities. The length of hospitalization for GPA/MPA patients varied from 7-13 days, with the longest stays for patients with associated renal disease. AAV patients represent a significant cost to the German healthcare system, especially during induction therapy. The high level of hospitalizations amongst AAV patients also represents a high usage of healthcare resources.