Treatment Patterns of Rare Immunodeficiencies With Special Regard to Antibiotics: A German Claims Data Analysis
Author(s)
Ulf Maywald, PhD1, Kirsten H Herrmann, PhD2, Detlef Boehler, Diplom3.
1payers gmbh, Hamburg, Germany, 2Market Access, Pharming Group, Leiden, Netherlands, 3BARMER, Berlin, Germany.
1payers gmbh, Hamburg, Germany, 2Market Access, Pharming Group, Leiden, Netherlands, 3BARMER, Berlin, Germany.
OBJECTIVES: Primary immune deficiencies (PID) are rare, difficult-to-manage disorders caused by inherited defects in cells of the immune system, resulting in increased risk of life-threatening infections or autoimmune diseases with no causal treatment yet. This study analyzes German payer-claims-database to understand the follow-up, therapies required, antibiotic usage for patients with PIDs.
METHODS: A algorithm was used to identify PID patients in a representative claims-database (n=9 million patients, BARMER from 07/2019 to 06/23). Claims data from 40.630 patients with diagnosis of PID (ICD 10 D81/83/84) were analyzed. The analysis considered outpatient prescriptions of antibiotics, oral corticosteroids (OCS), immunosuppressants, diagnostic procedures and healthcare resource use.
RESULTS: Projecting the numbers to Germany, about 350.000 patients should be diagnosed with PID. Out of the 40.630 PID patients in the database, 11.682 received no specific treatment, 2.975 received OCS only, 14.516 antibiotics only and 11.457 OCS and antibiotics. Only 2.082 patients received genetic-testing to differentiate the specific type of the PID. 5.363 patients receive >4 prescriptions of antibiotics per year, 1.148 of those patients were additionally diagnosed with bronchitis and/or bronchiectasis. Few patients get up to twenty prescriptions of antibiotics per year. Out of the whole claims-database (not only patients with a PID diagnosis) 10.233 patients received two or more prescriptions of antibiotics between May and October. A period usually free of infections.
CONCLUSIONS: PID Patients have a high burden of infectious diseases and receive often repetitive antibiotic courses. Genetic testing for differentiating the type of PID is low and should be improved. Two or more antibiotic courses during summer should be considered as potential case for immunodeficiency and induce further clarification. These findings underscore the need for awareness whilst prescribing antibiotics (especially as this can occur by different physicians for the same patient). The claims-data-analysis can identify potentially affected patients, this leads to a faster diagnosis of PID.
METHODS: A algorithm was used to identify PID patients in a representative claims-database (n=9 million patients, BARMER from 07/2019 to 06/23). Claims data from 40.630 patients with diagnosis of PID (ICD 10 D81/83/84) were analyzed. The analysis considered outpatient prescriptions of antibiotics, oral corticosteroids (OCS), immunosuppressants, diagnostic procedures and healthcare resource use.
RESULTS: Projecting the numbers to Germany, about 350.000 patients should be diagnosed with PID. Out of the 40.630 PID patients in the database, 11.682 received no specific treatment, 2.975 received OCS only, 14.516 antibiotics only and 11.457 OCS and antibiotics. Only 2.082 patients received genetic-testing to differentiate the specific type of the PID. 5.363 patients receive >4 prescriptions of antibiotics per year, 1.148 of those patients were additionally diagnosed with bronchitis and/or bronchiectasis. Few patients get up to twenty prescriptions of antibiotics per year. Out of the whole claims-database (not only patients with a PID diagnosis) 10.233 patients received two or more prescriptions of antibiotics between May and October. A period usually free of infections.
CONCLUSIONS: PID Patients have a high burden of infectious diseases and receive often repetitive antibiotic courses. Genetic testing for differentiating the type of PID is low and should be improved. Two or more antibiotic courses during summer should be considered as potential case for immunodeficiency and induce further clarification. These findings underscore the need for awareness whilst prescribing antibiotics (especially as this can occur by different physicians for the same patient). The claims-data-analysis can identify potentially affected patients, this leads to a faster diagnosis of PID.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE737
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), Rare & Orphan Diseases