The population in Germany is increasingly suffering from autoimmune diseases

10.05.2021 10:51

The frequency of autoimmune diseases such as ulcerative colitis, Crohn's disease, multiple sclerosis, psoriasis and rheumatoid arthritis has increased steadily in recent years. From 2012 to 2018, the proportion of patients with statutory health insurance with at least one of these autoimmune disease diagnoses increased from 3.5 to 4 percent. In 2018, 2.9 million policyholders were affected by one of these autoimmune diseases. This corresponds to an increase of around 500,000 patients since 2012.

Psoriasis affected a total of 1.8 percent of all those with statutory health insurance in 2018, making it the most common of the five autoimmune diseases, ahead of rheumatoid arthritis (1.4 percent). The relative increase in prevalence was greatest for Crohn's disease, with an increase of 25 percent. Overall, women were affected significantly more often than men, at 61 percent.

At the same time, the proportion of autoimmune patients receiving biologic therapy increased. While in 2012 61 out of 1,000 affected insured persons were treated with biologics, in 2018 the figure was already 86 out of 1,000. This corresponds to an increase of 43 percent. Since the number of patients with autoimmune diseases increased at the same time, the number of those receiving biologic therapy (2012: 145,897 / 2019: 250,036) even increased by 73 percent.

These are the central results of a care atlas study by the Central Institute for Statutory Health Insurance (Zi) on nationwide prescription trends for biological drugs for common autoimmune diseases between 2012 and 2018. “Autoimmune diseases are often accompanied by various concomitant and secondary diseases. They therefore often require complex treatment strategies. In this respect, the increase in the number of illnesses places special demands on targeted medical care,” said Zi CEO Dr. Dominik von Stillfried.

With the exception of multiple sclerosis, all diseases showed a steady increase in the number of patients treated with biologics over time. The two inflammatory bowel diseases and psoriasis each showed increase rates of over 100 percent. Despite the decline, patients suffering from multiple sclerosis still recorded the highest use of biologics in all years.

In addition to other drugs and treatment approaches, biologics are important therapeutic options for all five autoimmune diseases studied. In contrast to many other medicinal products, they are not manufactured chemically but using biotechnological processes. These are mostly complex proteins that are very similar to the body's own substances. Biological medicines are an important growth market for the pharmaceutical industry and are usually among the high-priced medicines. In 2018, 23 biological drugs were available in Germany for the treatment of the autoimmune diseases ulcerative colitis, Crohn's disease, MS, psoriasis and rheumatoid arthritis. A total of seven of these drugs were approved after 2012 and have therefore only been available for the treatment of patients with autoimmune diseases for a relatively short period of time.

The database was based on the nationwide drug prescription data in accordance with Section 300 Paragraph 2 SGB V and the nationwide statutory medical billing data in accordance with Section 295 SGB V. The diagnosis prevalence for the diseases ulcerative colitis, Crohn's disease, multiple sclerosis (MS), psoriasis and rheumatoid arthritis is in 2012 Until 2018, it was determined in the collective of insured persons of the statutory health insurance (GKV) at the federal level and for the areas of the statutory health insurance associations (17 regions). Insured persons were recorded as ill in a year if they had a confirmed diagnosis for at least two quarters.

Holstiege J, Klimke K, Akmatov MK, Kohring C, Dammertz L, Bätzing J. Nationwide prescription trends for biological drugs in common autoimmune diseases, 2012 to 2018. Central Institute for Statutory Health Insurance Physician Care in Germany (Zi). Supply Atlas Report No. 21/03. Berlin 2021. > https://doi.org/10.20364/VA-21.03