AS Places Large Financial Burden on German Healthcare System, Study Finds

Ankylosing spondylitis places a large financial burden on the German healthcare system, especially the costs of certain medications and patient hospitalizations, a study finds.

The results, “Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysis,” were published in Rheumatology International.

Ankylosing spondylitis (AS) is a debilitating form of arthritis that mainly affects the joints of the spine, causing chronic pain and lifelong physical disability. Usually patients start experiencing the first symptoms between ages 20–30. However, most only receive their diagnosis much later in their lives.

“Hence, AS mainly affects people of the working population, which highlights the socioeconomic impact due to disease-related work disability, sick leave, and early retirement,” the authors noted. However, studies based on real-life data assessing the financial impact of AS on the German healthcare system have been scarce.

In this study, the researchers analyzed and compared the healthcare resource utilization costs of AS patients living in Germany compared to those of individuals from the general population who did not have the disorder, using anonymized health claims data from the German Statutory Health Insurance (SHI) system.

The non-interventional, retrospective matched cohort study analyzed records that had been stored at the SHI system between January 2011 and December 2014. During the enrollment period, which took place during 2013, 10,208 AS patients were identified and included in the study.

Each patient was then matched to five individuals from the general population of a similar age and gender, who had a similar history of hospitalizations and an identical Charlson Comorbidity Index (CCI) score (a score that reflects the chance a person has of dying based on the presence of certain comorbidities).

Total healthcare resource utilization and direct costs were analyzed and compared between AS patients and individuals from the general population who did not have the disorder during 2013.

Compared to a group of 51,040 individuals from the general population, the total healthcare resource utilization, which included the number of prescriptions, medical devices, sick leaves, visits to the hospital/clinic, and hospitalizations was higher among AS patients.

Moreover, the study found that on average, the total healthcare costs of AS patients were approximately €2,475 ($2,742) higher compared to those of individuals from the general population during 2013. According to the study, the biggest cost drivers were hospitalizations and biologic disease-modifying anti-rheumatic drugs (bDMARDS), which were prescribed to approximately 10% of the patients included in the study.

“This study utilizing real-world data from a large German health insurance claims database revealed that AS patients have to carry a high burden of disease and impose significant costs for the German healthcare system when compared to the control cohort from the general population,” the researchers said. “To capture the whole burden of AS, supplemental research in terms of patient-reported outcomes, clinical characteristics, and further pharmaceutical treatment as well as indirect and intangible costs is necessary.”