Treatment Patterns and Healthcare Resource Utilization Among Patients with Atopic Dermatitis: A Retrospective Cohort Study Using German Health Claims Data

Abstract

Introduction: Atopic dermatitis (AD) is a common inflammatory skin disease. Many patients are initiating a systemic therapy, if the disease is not adequately controlled with topical treatment only. Currently, there is little real-world evidence on the AD-related medical care situation in Germany. This study analyzed patient characteristics, treatment patterns, healthcare resource utilization and costs associated with systemically treated AD for the German healthcare system.Methods: In this descriptive, retrospective cohort study, aggregated anonymized German health claims data from the InGef research database were used. Within a representative sample of four million insured individuals, patients with AD and systemic drug therapy initiation (SDTI) in the index year 2017 were identified and included into the study cohort. Systemic drug therapy included dupilumab, systemic corticosteroids (SCS) and systemic immunosuppressants (SIS). Patients were observed for one year starting from the date of SDTI in 2017. Results: 9975 patients were included (57.8% female, mean age 39.6 years [SD 25.5]). In the one-year observation period, the most common systemic drug therapy was SCS ([ 99.0%). Administrations of dupilumab (0.3%) or dispensations of SIS were rare (cyclosporine: 0.5%, azathioprine: 0.6%, methotrexate: 0.1%). Median treatment duration of SCS, cyclosporine and

Real‐world treatment patterns of Finnish adult patients with atopic dermatitis: From topicals to systemic therapy

“…18 Moreover, TCIs are reimbursed only when initiated by a dermatologist, directing initiations to secondary care. Consistent with previous studies, 2,14,19 the results showed low level of phototherapy and systemic therapy use among AD patients.…”

“…This was also supported by the long time to the potential next systemic treatment. The use of SCS was notably low (0.4% in all patients and 1.5% in patients with severe AD) compared with data from other countries, 12,15,19 but in line with the European guidelines 8…”

“…This was also supported by the long time to the potential next systemic treatment. The use of SCS was notably low (0.4% in all patients and 1.5% in patients with severe AD) compared with data from other countries, 12,15,19 but in line with the European guidelines. 8 Overall, patients with severe AD and systemic medication were found older, more often male, and with lower educational level than those without systemic medication.…”

Patient-reported assessment of medical care for chronic inflammatory skin diseases: an enterprise-based survey

“…We speculate that restrictions in medical care due to racial and ethnic aspects, which are relevant in other parts of the world ( 31 ), are not likely to have a relevant impact in our study. We rather suspect that the major cause for insufficient current medical care is a disappointment with medical care due to either delay in diagnosis [e.g., HS ( 32 )], a limited efficacy of approved drugs [e.g., HS ( 13 )], or the doctors’ hesitation to prescribe expensive, albeit highly effective drugs ( 33 , 34 ). Regarding prescriptions, the most prevalent barriers to prescription of biologics reported by physicians in Germany in 2017 were the high cost, the low reimbursement and the fear of recourse ( 35 ).…”