Late Treatment in Adults With Neurogenic Bowel Dysfunction: A Retrospective Analysis of German Claims Data
Author(s)
Naveen Surendranathan, MSc1, Matthias Arnold, Dr. oec. publ Health Economics2, Claudia Grellmann, Dr. rer. nat, Bioinformatik2, Helge Blumenroth, Ms Public Health Science with Health Economics3, Sebastian Schwabe, Dr. rer. nat. Experimental Virology3.
1Manager Health Economist, Coloplast, Hamburg, Germany, 2inav, Berlin, Germany, 3Coloplast GmbH, Hamburg, Germany.
1Manager Health Economist, Coloplast, Hamburg, Germany, 2inav, Berlin, Germany, 3Coloplast GmbH, Hamburg, Germany.
OBJECTIVES: This study examines the timing of treatment initiation for Neurogenic Bowel Dysfunction (NBD) and Functional Bowel Dysfunction (FBD) in Germany. NBD is a common complication in individuals with neurological disorders, and timely bowel management is essential for maintaining health, dignity, and quality of life (QoL) of the patients.
METHODS: A retrospective analysis was conducted using the DADB (Database for Evaluation and Health Services Research), covering 4.1 million individuals insured under the German statutory health system from 2013 to 2022. Data were extrapolated to German statutory health insurance system to estimate national trends. A longitudinal analysis assessed the average time from initial diagnosis to treatment initiation. A systematic literature review was also performed using keywords such as management, guidelines and quality of life for NBD and FBD patients on PubMed and Google Scholar.
RESULTS: Treatment options were categorized as non-invasive, minimally invasive, and invasive. The Kaplan-Meier based median delay in initiating treatment was 3.5 years post-diagnosis. Although some over—the—counter (OTC) treatments may not be captured from database, this delay remains substantial. Clinical guidelines for conditions such as spinal cord injury, multiple sclerosis, and Parkinson’s disease emphasize early bowel management —often within weeks of diagnosis— to prevent complications (Truzzi et al., 2022). Bowel management should focus on reducing bowel-related complications and to improve patients QoL (Kurze et al., 2022). The therapy pyramid may serve as a useful framework for tailoring treatment based on the severity of NBD symptoms (Emmanuel et al., 2013).
CONCLUSIONS: The findings reveal a significant gap in timely NBD management in Germany. Early intervention is critical to improving outcomes and reducing long-term healthcare burdens. These results highlight the need for increased awareness, earlier diagnosis, and prompt treatment initiation in patients with neurological conditions.
METHODS: A retrospective analysis was conducted using the DADB (Database for Evaluation and Health Services Research), covering 4.1 million individuals insured under the German statutory health system from 2013 to 2022. Data were extrapolated to German statutory health insurance system to estimate national trends. A longitudinal analysis assessed the average time from initial diagnosis to treatment initiation. A systematic literature review was also performed using keywords such as management, guidelines and quality of life for NBD and FBD patients on PubMed and Google Scholar.
RESULTS: Treatment options were categorized as non-invasive, minimally invasive, and invasive. The Kaplan-Meier based median delay in initiating treatment was 3.5 years post-diagnosis. Although some over—the—counter (OTC) treatments may not be captured from database, this delay remains substantial. Clinical guidelines for conditions such as spinal cord injury, multiple sclerosis, and Parkinson’s disease emphasize early bowel management —often within weeks of diagnosis— to prevent complications (Truzzi et al., 2022). Bowel management should focus on reducing bowel-related complications and to improve patients QoL (Kurze et al., 2022). The therapy pyramid may serve as a useful framework for tailoring treatment based on the severity of NBD symptoms (Emmanuel et al., 2013).
CONCLUSIONS: The findings reveal a significant gap in timely NBD management in Germany. Early intervention is critical to improving outcomes and reducing long-term healthcare burdens. These results highlight the need for increased awareness, earlier diagnosis, and prompt treatment initiation in patients with neurological conditions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD114
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Gastrointestinal Disorders, Neurological Disorders