Incidence and Prevalence of Primary Biliary Cholangitis (PBC) and Cholestatic Pruritus (CP) in Germany: Results From a Statutory Health Insurance (SHI) Claims Analysis
Author(s)
Laura Weber, M.Sc.1, Silvia Dombrowski, PhD2, Veronika Simang, M.Sc.1, Simon Hohenester, MD, PhD1, Adrian Wilk, PhD3, Céline Vetter, PhD4.
1GlaxoSmithKline GmbH & co. KG, Munich, Germany, 2IQVIA Commercial GmbH & Co. OHG, Frankfurt am Main, Germany, 3Team Gesundheit, Gesellschaft für Gesundheitsmanagement mbH, Essen, Germany, 4IQVIA Commercial GmbH & Co. OHG, Frankfurt a.M., Germany.
1GlaxoSmithKline GmbH & co. KG, Munich, Germany, 2IQVIA Commercial GmbH & Co. OHG, Frankfurt am Main, Germany, 3Team Gesundheit, Gesellschaft für Gesundheitsmanagement mbH, Essen, Germany, 4IQVIA Commercial GmbH & Co. OHG, Frankfurt a.M., Germany.
OBJECTIVES: To quantify the incidence, prevalence, and treatment patterns of primary biliary cholangitis (PBC) and cholestatic pruritus (CP) in Germany.
METHODS: These retrospective claims analyses identified incident and prevalent PBC patients from 2014-2021 amongst 4.6 million SHI patients with ≥2 years of enrollment, using ≥1 ICD-10-GM code for PBC (K74.3) and ≥3 prescriptions for PBC treatments (UDCA or OCA). As CP lacks a specific ICD-10 code, patients also required ≥1 pruritus diagnosis (L29.8) and/or ≥1 CP treatment prescription. We report CP incidence and prevalence rates among PBC patients, trends over time, and the proportion treated with cholestyramine.
RESULTS: We identified a total of 1,378 incident and 2,275 prevalent PBC cases. Annual PBC incidence rates ranged 3.3 to 5.2/100,000 per year, with observed PBC prevalence rates between 30 to 49 per 100,000 inhabitants from 2014-2021. The mean age of PBC patients at diagnosis was 59.4 (SD=13.8), and 78% of PBC patients were female. As expected, the prevalence was higher in patients ≥65 years, ranging from 54-93/100,000 across the study period, as compared to 21-33/100,000 in those <65 years of age. The overall CP prevalence was 18.8%, and the annual proportion of PBC patients with CP increased from 5,9% in 2014 to 7,8% in 2021. Mean age at pruritus onset was 62.2 years (SD = 14.2), on average 3 years after PCB onset; 85% of patients were female. Cholestyramine use in PBC patients with CP declined from 17.7% in 2014 to 4.0% in 2021, while bezafibrate use increased from 1.6% to 11.8%.
CONCLUSIONS: Pruritus is a common symptom in PBC, especially in female patients. However, treatment patterns in Germany show decreasing reliance on cholestyramine, with increasing use of alternative therapies.
METHODS: These retrospective claims analyses identified incident and prevalent PBC patients from 2014-2021 amongst 4.6 million SHI patients with ≥2 years of enrollment, using ≥1 ICD-10-GM code for PBC (K74.3) and ≥3 prescriptions for PBC treatments (UDCA or OCA). As CP lacks a specific ICD-10 code, patients also required ≥1 pruritus diagnosis (L29.8) and/or ≥1 CP treatment prescription. We report CP incidence and prevalence rates among PBC patients, trends over time, and the proportion treated with cholestyramine.
RESULTS: We identified a total of 1,378 incident and 2,275 prevalent PBC cases. Annual PBC incidence rates ranged 3.3 to 5.2/100,000 per year, with observed PBC prevalence rates between 30 to 49 per 100,000 inhabitants from 2014-2021. The mean age of PBC patients at diagnosis was 59.4 (SD=13.8), and 78% of PBC patients were female. As expected, the prevalence was higher in patients ≥65 years, ranging from 54-93/100,000 across the study period, as compared to 21-33/100,000 in those <65 years of age. The overall CP prevalence was 18.8%, and the annual proportion of PBC patients with CP increased from 5,9% in 2014 to 7,8% in 2021. Mean age at pruritus onset was 62.2 years (SD = 14.2), on average 3 years after PCB onset; 85% of patients were female. Cholestyramine use in PBC patients with CP declined from 17.7% in 2014 to 4.0% in 2021, while bezafibrate use increased from 1.6% to 11.8%.
CONCLUSIONS: Pruritus is a common symptom in PBC, especially in female patients. However, treatment patterns in Germany show decreasing reliance on cholestyramine, with increasing use of alternative therapies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH140
Topic
Epidemiology & Public Health
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)