LONGITUDINAL ANALYSIS OF EOSINOPHILIC ESOPHAGITIS IN CLAIMS DATA BEFORE THE INTRODUCTION OF A SPECIFIC ICD-10-GM-CODE
Author(s)
Inger Hellerhoff, Dr.1, Jessica Handke, Dr.2, Isabel Karkossa, Dr.1, Beate Leppert, Dr.1, Joachim Labenz, Prof. Dr.3, Ahmed Madisch, Prof. Dr.4, Uta Luise Henriette Heidenblut, M.Sc.2.
1Gesundheitsforen Leipzig, Leipzig, Germany, 2Dr. Falk Pharma GmbH, Freiburg, Germany, 3Privatpraxis für Gastroenterologie im Medizinischen Zentrum Siegerlandflughafen, Burbach, Germany, 4DIAKOVERE Friederikenstift, Zentrum für Innere Medizin, Hannover, Germany.
1Gesundheitsforen Leipzig, Leipzig, Germany, 2Dr. Falk Pharma GmbH, Freiburg, Germany, 3Privatpraxis für Gastroenterologie im Medizinischen Zentrum Siegerlandflughafen, Burbach, Germany, 4DIAKOVERE Friederikenstift, Zentrum für Innere Medizin, Hannover, Germany.
OBJECTIVES: Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus characterized by esophageal dysfunction. Population-based epidemiological and treatment data are lacking for Germany. A specific ICD-10-GM code for EoE (K20.0) was introduced only in 2023. Before, EoE was included under esophagitis (K20), posing major challenges for longitudinal population-level studies.
METHODS: A retrospective, observational database study using claims data from a German statutory health insurance (SHI) database (DADB, ~ 4.4 million individuals 2013-2023) was conducted to address these gaps. Two different approaches were tested to identify EoE cases before 2023: i) identifying EoE patients among K20 patients based on endoscopy, biopsy/histology, and EoE-specific treatment (corticosteroids/proton pump inhibitors (PPI)/dupilumab/balloon dilatation/bougie insertion), ii) tracing back EoE patients confirmed by K20.0 in 2023.
RESULTS: Overall, 1,221 prevalent EoE-patients were identified in the DADB in 2023, corresponding to 30,288 in SHI (CIL: 28,684; CIU: 32,003). Notably, the codes for endoscopy and biopsy/histology expected were rarely used, i.e. only 10.00% of prevalent EoE patients received both (German Procedure Classification [OPS] 1-632 and 1-440.9), further reduced to 6.76% when filtering for treatment. Therefore, we decided to identify EoE patients in 2023 and trace them back to their first K20 diagnosis (after ≥ 3 K20-free years; DADB = 410; SHI = 12,868; CIL: 11,672; CIU: 14,215). For these patients, longitudinal treatment was assessed, unraveling that 61.27% of first-line therapies consisted of PPIs and that PPIs dominated subsequent treatment lines as well.
CONCLUSIONS: The findings suggest that EoE diagnostics considerably deviate from current guidelines. Other codes than expected appear more frequently, e.g. endoscopy according to the “German Uniform Value Scale” (EBM) code 13400 and biopsy/histology according to EBM 19310. However, we were able to identify a reliable EoE population, whose treatment was monitored over time, thus filling existing data gaps regarding the epidemiology and treatment of EoE (mainly with PPIs).
METHODS: A retrospective, observational database study using claims data from a German statutory health insurance (SHI) database (DADB, ~ 4.4 million individuals 2013-2023) was conducted to address these gaps. Two different approaches were tested to identify EoE cases before 2023: i) identifying EoE patients among K20 patients based on endoscopy, biopsy/histology, and EoE-specific treatment (corticosteroids/proton pump inhibitors (PPI)/dupilumab/balloon dilatation/bougie insertion), ii) tracing back EoE patients confirmed by K20.0 in 2023.
RESULTS: Overall, 1,221 prevalent EoE-patients were identified in the DADB in 2023, corresponding to 30,288 in SHI (CIL: 28,684; CIU: 32,003). Notably, the codes for endoscopy and biopsy/histology expected were rarely used, i.e. only 10.00% of prevalent EoE patients received both (German Procedure Classification [OPS] 1-632 and 1-440.9), further reduced to 6.76% when filtering for treatment. Therefore, we decided to identify EoE patients in 2023 and trace them back to their first K20 diagnosis (after ≥ 3 K20-free years; DADB = 410; SHI = 12,868; CIL: 11,672; CIU: 14,215). For these patients, longitudinal treatment was assessed, unraveling that 61.27% of first-line therapies consisted of PPIs and that PPIs dominated subsequent treatment lines as well.
CONCLUSIONS: The findings suggest that EoE diagnostics considerably deviate from current guidelines. Other codes than expected appear more frequently, e.g. endoscopy according to the “German Uniform Value Scale” (EBM) code 13400 and biopsy/histology according to EBM 19310. However, we were able to identify a reliable EoE population, whose treatment was monitored over time, thus filling existing data gaps regarding the epidemiology and treatment of EoE (mainly with PPIs).
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH9
Topic
Epidemiology & Public Health, Methodological & Statistical Research
Disease
Gastrointestinal Disorders, No Additional Disease & Conditions/Specialized Treatment Areas