Situation of Rheumatoid Arthritis Patients Treated with Biologics In Germany Based on a Claims Data Analysis

Abstract

Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatic joint disease in industrialized countries. This study provides information on the current supply with biological agents and its related costs in Germany. A retrospective claims data analysis was conducted utilizing the Institute for Applied Health Research (InGef) Berlin, formerly HRI Health Risk Institute, database including approximately 6.7 million insured anonymities originating from 63 statutory health insurances. Analyses were performed by the InGef institute. A sample with approximately 4 million insured persons was drawn and stratified by age and gender according to the official demographic structure of the German statutory health insured population (DeStatis, Dec 31st, 2013). Patients between 2012 - 2016 were included if they met the following conditions: Main diagnosis of RA (ICD-10 code M05.- and M06.-), and start / maintenance / switch of treatment with RA approved biological agent(s) (at least for three months). The study evaluated hospitalization, change in medication and direct medical costs (drug, outpatient care, hospitalization). The level of share of prescriptions of all biological agents considered is low. Etanercept and adalimumab are administered mostly to patients already on treatment (in 2015 etanercept 32.7 % vs. adalimumab 28.9 %). The total costs of the included 4’233 patients add up to € 78’202’566 in 2015. The total number of patients, the number of hospital admissions and the total treatment costs including all individual cost items (costs of biological agents /other medication / outpatient care / hospitalizations) grew yearly on average between 7.7 % and 18.9 % (2012 – 2015). Hospitalization per patient remained constant at 0.8. Etanercept and adalimumab and are those biological agents mainly used by patients already on treatment. Costs grew steadily over the last four years. Total costs in 2015 were € 78.2 million (on average € 18’475 per patient).