Value of a national administrative database to guide public decisions: From the système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France

Tuppin, Philippe; Rudant, Jérémie; Constantinou, Panayotis; Gastaldi-Ménager, Christelle; Rachas, Antoine; Roquefeuil, L. de; Maura, Géric; Caillol, H.; Tajahmady, Ayden; Coste, Joël; Gissot, Claude; Weill, Alain; Fagot-Campagna, A.

doi:10.1016/j.respe.2017.05.004

Cited by 605 publications

(555 citation statements)

References 41 publications

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“…This study presents 2 main limitations. First of all, although health care claims data can be exhaustive, readily available, and reasonably inexpensive, making them attractive for large‐scale studies, they are not designed for research purposes, unlike registries or, more generally, ad hoc prospectively collected databases, and can be susceptible to misclassification . In our study, the proposed algorithm was based on ICD‐10 diagnosis codes and medical procedure codes that may be subject to coding errors, and data from medical records could not be used to validate pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…This study was conducted using the French national health insurance information system (SNIIRAM), which consists of 2 French nationwide datasets linked by a unique patient identifier: the French national health insurance database (DCIR) and the French hospital discharge database (PMSI). French national health insurance covers the entire French population and is divided into several specific schemes, including the general scheme for salaried workers (87% of the population), the self‐employed workers scheme (6%), the farmers scheme (5%), and other additional schemes covering the remaining 2% …”

Section: Methodsmentioning

confidence: 99%

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Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Blotière

Weill

Dalichampt

et al. 2018

Pharmacoepidemiology and Drug

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PurposeAccess to claims databases provides an opportunity to study medication use and safety during pregnancy. We developed an algorithm to identify pregnancy episodes in the French health care databases and applied it to study antiepileptic drug (AED) use during pregnancy between 2007 and 2014.MethodsThe algorithm searched the French health care databases for discharge diagnoses and medical procedures indicative of completion of a pregnancy. To differentiate claims associated with separate pregnancies, an interval of at least 28 weeks was required between 2 consecutive pregnancies resulting in a birth and 6 weeks for terminations of pregnancy. Pregnancy outcomes were categorized into live births, stillbirths, elective abortions, therapeutic abortions, spontaneous abortions, and ectopic pregnancies. Outcome dates and gestational ages were used to calculate pregnancy start dates.ResultsAccording to our algorithm, live birth was the most common pregnancy outcome (73.9%), followed by elective abortion (17.2%), spontaneous abortion (4.2%), ectopic pregnancy (1.1%), therapeutic abortion (1.0%), and stillbirth (0.4%). These results were globally consistent with French official data. Among 7 559 701 pregnancies starting between 2007 and 2014, corresponding to 4 900 139 women, 6.7 per 1000 pregnancies were exposed to an AED. The number of pregnancies exposed to older AEDs, comprising the most teratogenic AEDs, decreased throughout the study period (−69.4%), while the use of newer AEDs increased (+73.4%).ConclusionsWe have developed an algorithm that allows identification of a large number of pregnancies and all types of pregnancy outcomes. Pregnancy outcome and start dates were accurately identified, and maternal data could be linked to neonatal data.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Blotière

Weill

Dalichampt

et al. 2018

Pharmacoepidemiology and Drug

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“…This study was conducted using the SNDS (Système National des Données de Santé) French nationwide health administrative database . This database covers more than 99% of the French population (around 65 000 000 people).…”

Section: Methodsmentioning

confidence: 99%

The effectiveness and safety of infliximab compared with biosimilar CT‐P13, in 3112 patients with ulcerative colitis

Meyer

Rudant

Drouin

et al. 2019

Aliment Pharmacol Ther

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Summary Background CT‐P13, a biosimilar of the reference product infliximab, has been approved for the treatment of ulcerative colitis on the basis of the results of trials conducted in patients with spondyloarthritis and rheumatoid arthritis. Aim To compare the effectiveness and safety of CT‐P13 and the reference product in infliximab‐naive patients with ulcerative colitis Methods A comparative real‐life equivalence cohort study was conducted using the French nationwide health administrative database. Infliximab‐naive patients with ulcerative colitis over 15 years of age who started infliximab with no other indications for infliximab were included. The primary outcome was a composite endpoint (death, ulcerative colitis‐related surgery, all‐cause hospitalisation and reimbursement for other biologics). Equivalence was defined as a 95% CI of the hazard ratio (HR) of CT‐P13 vs the reference product, in a multivariable marginal Cox model situated within prespecified margins of (0.80‐1.25). Results A total of 3112 patients were included between 1 January 2015 and 30 June 2017: 1434 received the reference product, 1678 received CT‐P13. Overall, 710 patients in the reference product group and 743 patients in the CT‐P13 group met the composite endpoint. In multivariable analysis of the primary outcome, CT‐P13 was equivalent to the reference product (HR 1.04; 95% CI: 0.94‐1.15). The number of serious infections was lower in the CT‐P13 group (HR 0.65; 95% CI: 0.48‐0.88). There was no difference in the incidence of solid or haematologic malignancy (HR 0.81; 95% CI: 0.41‐1.60). Conclusions The effectiveness of CT‐P13 is equivalent and the risk of serious infections could be lower than that of the reference product for infliximab‐naive patients with ulcerative colitis.

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“…In France, the SNDS compiles data from the French National Health Insurance System (including the national hospital‐discharge summaries database system—PMSI) . Information on health care reimbursement, ambulatory, and hospital expenditures data, as well as sociodemographics including age, gender, French administrative area of residence, advantage of the Complementary Universal Health Coverage (CMU‐C, an individual measure of low socioeconomic position [SEP]), and long‐term chronic disease status allowing for full medical reimbursement, is available in the SNDS.…”

Section: Methodsmentioning

confidence: 99%

Impact of a population‐based asthma management program in France (Sophia Asthme): A matched controlled before‐and‐after quasi‐experimental study using the French health insurance database (SNDS)

Dib

Rycke

Lafourcade

et al. 2019

Pharmacoepidemiology and Drug

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Purpose Sophia Asthme (SA) is a chronic disease management program of the French national health insurance for adult patients with asthma. We evaluated the early impact of this intervention. Methods We conducted a matched controlled, before‐and‐after quasi‐experimental study within the French Health Insurance Database (Système National Des Données de Santé [SNDS]). The SA program was implemented in a set of 18 Départements in France and targeted 18‐ to 44‐year‐old subjects, with at least two reimbursement dates for asthma drug therapy during the 12‐month period prior to program targeting. Change in outcomes was assessed from the “before program” period (January‐December 2014) to the “after program implementation” period (March 2015‐February 2016) in the program group (eligible to SA program in the 18 Départements) and in the matched controlled group. The main outcome measure was the before‐after change in proportion of subjects with a controllers/(controllers+relievers) ratio greater than 50%. Results Of the 99 578 subjects of the program group, 9225 (9.3%) actually participated in SA program. The program had no significant impact on the proportion of subjects with a ratio greater than 50%. However, subjects exposed to SA program were significantly more likely to be dispensed controller medications (OR = 1.04; 95% CI, 1.01‐1.07) and to sustain their use of these medications (OR = 1.08; 95% CI, 1.05‐1.12). Conclusion We did not demonstrate any significant impact of the program on the primary outcome. The modest yet encouraging findings of this early evaluation suggest the need for reformulation of the program and its evaluation.

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Value of a national administrative database to guide public decisions: From the système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France

Cited by 605 publications

References 41 publications

Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

The effectiveness and safety of infliximab compared with biosimilar CT‐P13, in 3112 patients with ulcerative colitis

Impact of a population‐based asthma management program in France (Sophia Asthme): A matched controlled before‐and‐after quasi‐experimental study using the French health insurance database (SNDS)

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