BackgroundIn 2009 the Uterine Bleeding and Pain Women's Research Study (UBP-WRS) was conducted interviewing 21,479 women across 8 countries in order to gain patient-based prevalence data on uterine pain and bleeding indications and investigate uterine symptoms and women's treatment experiences. This article shows relevant results of the study for the indication uterine fibroids providing data on self-reported prevalence, symptomatology and management of uterine fibroids.Methods2,500 women (USA: 4,500 women) in each country (Brazil, Canada, France, Germany, Italy, South Korea, the UK, the USA) completed an online survey. Women included were in their reproductive age (age group 15-49 years; USA: 18-49 years) and had ever experienced menstrual bleedings. Quotas were applied for age, region, level of education and household income of respondents. Variables have been analyzed descriptively and exploratory statistical tests have been performed.ResultsThe self-reported prevalence of uterine fibroids ranged from 4.5% (UK) to 9.8% (Italy), reaching 9.4% (UK) to 17.8% (Italy) in the age group of 40-49 years. Women with a diagnosis of uterine fibroids reported significantly more often about bleeding symptoms than women without a diagnosis: heavy bleedings (59.8% vs. 37.4%), prolonged bleedings (37.3% vs. 15.6%), bleeding between periods (33.3% vs. 13.5%), frequent periods (28.4% vs. 15.2%), irregular and predictable periods (36.3% vs. 23.9%). Furthermore women with diagnosed uterine fibroids reported significantly more often about the following pain symptoms: pressure on the bladder (32.6% vs. 15.0%), chronic pelvic pain (14.5% vs. 2.9%), painful sexual intercourse (23.5% vs. 9.1%) and pain occurring mid-cycle, after and during menstrual bleeding (31.3%, 16.7%, 59.7%, vs. 17.1%, 6.4%, 52.0%). 53.7% of women reported that their symptoms had a negative impact on their life in the last 12 month, influencing their sexual life (42.9%), performance at work (27.7%) and relationship & family (27.2%).ConclusionsUterine fibroid is a common concern in women at fertile age causing multiple bleeding and pain symptoms which can have a negative impact on different aspects in women's life.

BackgroundHealthcare-utilization data for multiple sclerosis (MS) are scarce in Germany. The Purpose of the study was to analyse administrative prevalence of MS, medication use and type of specialists involved in MS treatment in the outpatient setting in Bavaria.MethodsPseudonymized claims data from Bavarian Statutory Health Insurance (SHI)-accredited physicians were used. Administrative prevalence of MS was defined as having ≥1 MS diagnosis (International Classification of Diseases, 10th edition, code G35) documented by a neurologist or psychiatrist, or ≥1 prescription for disease-modifying drugs (DMDs)). The administrative prevalence calculated for Bavaria was projected to Germany. DMD prescription and involvement of different specialities in health care service for MS patients was analysed.ResultsAdministrative prevalence of MS in Bavaria increased from 0.123% to 0.175% of insured persons between 2005 and 2009; when projected, this yielded ~102,000–143,000 patients with MS in the German population. The percentage of patients receiving ≥1 DMD prescription increased from 45.5% to 50.5%. Patients with MS were mainly treated by neurologists in the ambulatory care setting.ConclusionsThese results provide important information on the administrative prevalence of MS in Bavaria and on healthcare provision for patients, which is relevant for resource planning in the healthcare sector.

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Zusammenfassung Zielsetzung Mit dem Arzneimittelmarktneuordnungsgesetz (AMNOG) wurde 2011 die frühe Nutzenbewertung in Deutschland eingeführt. Die vorliegende Analyse untersucht, ob in den ersten zwei Jahren nach Markteinführung ein Unterschied in der Marktdurchdringung für Neueinführungen vor und nach AMNOG besteht und ob die Höhe des Zusatznutzens die Marktdurchdringung beeinflusst. Methodik Die Analyse betrachtet 65 bzw. 40 Wirkstoffe, die vor bzw. nach Einführung der frühen Nutzenbewertung in den Markt kamen (Prä- bzw. Post-AMNOG-Wirkstoffe). Markteinführung der Wirkstoffe war zwischen Januar 2005 und Dezember 2013. Die Marktdurchdringung wurde berechnet als Anteil des realen ambulanten Verbrauchs in der gesetzlichen Krankenversicherung gemessen in definierten Tagesdosen (DDD – „defined daily dose“) am zu erwartenden Verbrauch auf der Grundlage der Zielpopulation. Zur Operationalisierung des Zusatznutzens wurden die Beschlüsse des Gemeinsamen Bundesausschusses abhängig von Zusatznutzen und Ergebnissicherheit auf einer Ordinalskala bewertet. Ergebnisse Über alle Wirkstoffe hinweg erreichten die Post- im Vergleich zu den Prä-AMNOG-Wirkstoffen im Durchschnitt eine numerisch höhere Marktdurchdringung. Der Unterschied war nicht statistisch signifikant. An zwei Anwendungsgebieten wird beispielhaft gezeigt, dass die Marktdurchdringung von den spezifischen Marktgegebenheiten abhing. Es konnte kein Zusammenhang zwischen dem Ergebnis der Nutzenbewertung und der Höhe der Marktdurchdringung nachgewiesen werden. Schlussfolgerung Die Ergebnisse der Analyse geben weder einen Hinweis darauf, dass die frühe Nutzenbewertung die Anwendung neuer Arzneimittel fördert, noch dass sie diese behindert.