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Kratzer V, Rölz V, Bidlingmaier C, Klamroth R, Behringer J, Schramm A, Mansmann U, Berger K. Can German Health Insurance Claims Data Fill Information Gaps in Rare Chronic Diseases: Use Case of Haemophilia A. Hamostaseologie 2024. [PMID: 38950623 DOI: 10.1055/a-2276-4871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
Claims data are increasingly discussed to evaluate health care for rare diseases (resource consumption, outcomes and costs). Using haemophilia A (HA) as a use case, this analysis aimed to generate evidence for the aforementioned information using German Statutory Health Insurance (SHI) claims data. Claims data (2017-2019) from the German SHI 'AOK Bayern - Die Gesundheitskasse' were used. Patients with ICD-10-GM codes D66 and HA medication were included in descriptive analyses. Severity levels were categorized according to HA medication consumption. In total, 257 patients were identified: mild HA, 104 patients (mean age: 40.0 years; SD: 22.9); moderate HA, 17 patients, (51.2 years; SD: 24.5); severe HA, 128 patients, (34.2 years; SD: 18.5). There were eight patients categorized with inhibitors (37.8 years; SD: 29.6). Psychotherapy was reported among 28.8% (mild) to 32.8% (severe) of patients. Joint disease was documented for 46.2% (mild) to 61.7% (severe) of patients. Mean direct costs per patient per year were 1.34× for mild, 11× for moderate, 81× higher for severe HA patients and 223× higher for inhibitor patients than the mean annual expenditure per AOK Bayern insurant (2019). German SHI data provide comprehensive information. The patient burden in HA is significant with respect to joint disease and psychological stress regardless of the HA severity level. The cost of HA care for patients is high. Large cost ranges suggest that the individual situation of a patient must be considered when interpreting costs. The main limitation of SHI data analysis for HA was the lack of granularity of ICD codes.
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Affiliation(s)
- Vanessa Kratzer
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig Maximilian University of Munich, Munich, Germany
- Comprehensive Cancer Center, CCC München LMU, Munich, Germany
| | - Verena Rölz
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Christoph Bidlingmaier
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Ludwig Maximilian University Hospital, Munich, Germany
| | - Robert Klamroth
- Vivantes Klinikum im Friedrichshain, Klinik für Innere Medizin Angiologie und Hämostaseologie, Berlin, Germany
| | - Jochen Behringer
- AOK Bayern - Die Gesundheitskasse Bereich Exzellenzzentrum Analytik u. Daten Fachbereich Datengovernance, AOK Bayern, München, Germany
| | - Anja Schramm
- AOK Bayern - Die Gesundheitskasse Bereich Exzellenzzentrum Analytik u. Daten Fachbereich Datengovernance, AOK Bayern, München, Germany
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig Maximilian University of Munich, Munich, Germany
| | - Karin Berger
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig Maximilian University of Munich, Munich, Germany
- Medizinische Klinik und Poliklinik III, Ludwig Maximilian University Hospital, Munich, Germany
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Jonker CJ, Bakker E, Kurz X, Plueschke K. Contribution of patient registries to regulatory decision making on rare diseases medicinal products in Europe. Front Pharmacol 2022; 13:924648. [PMID: 35991868 PMCID: PMC9386590 DOI: 10.3389/fphar.2022.924648] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/29/2022] [Indexed: 12/18/2022] Open
Abstract
Between 2000 and 2021, the European Medicines Agency (EMA) assigned the orphan designation to over 1,900 medicines. Due to their small target populations, leading to challenges regarding clinical trial recruitment, study design and little knowledge on the natural history of the disease, the overall clinical evidence submitted at the time of marketing authorisation application for these medicines is often limited. Patient registries have been recognised as important sources of data on healthcare practices, drug utilisation and clinical outcomes. They may help address these challenges by providing information on epidemiology, standards of care and treatment patterns of rare diseases. In this review, we illustrate the utility of patient registries across the different stages of development of medicinal products, including orphans, to provide evidence in the context of clinical studies and to generate post-authorisation long term data on their effectiveness and safety profiles. We present important initiatives leveraging the role of registries for orphan medicinal products' development and monitoring to ultimately improve patients' lives.
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Affiliation(s)
- Carla J. Jonker
- European Medicines Agency (EMA), Amsterdam, Netherlands
- Dutch Medicines Evaluation Board (CBG‐MEB), Utrecht, Netherlands
| | - Elisabeth Bakker
- European Medicines Agency (EMA), Amsterdam, Netherlands
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), Groningen, Netherlands
| | - Xavier Kurz
- European Medicines Agency (EMA), Amsterdam, Netherlands
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