OBJECTIVES: Biologics are drugs with a large economic burden for health care providers and should only be given to patients with a sever autoimmune disease like rheumatoid arthritis (RA), ankylosing spondylitis (AS) or psoriatic arthritis(PS). The aim of this study was to evaluate the prescription reality of biologics within these diagnoses. METHODS: To examine the prescription reality of biologics, prescriptions of a large German claims data base were evaluated. Demographic, prescription and diagnosis data was taken from 2007 to 2013 to identify the prescription routine on a yearly basis. This study included 42,441 to 92,059 patients per year suffering from RA, PS or AS and their observed prescriptions of biologics. Patients were only included if they were fully observable in the specific year of analysis. RESULTS: :  The underlying base population of the whole claims data base (n = 3,6m) is fairly comparable to the overall German population regarding age, gender, morbidity and mortality. In 2013 84,645 AS patients, 37,839 PS and 56,570 RA patients could be observed, where 58,45% are female (mean age = 57,55 years). Overall, the prescription ratio of biologics increased from 1,61% in 2007 to 3,43% in 2013. Concerning gender, no difference in the probability of biologics prescriptions could be observed (57,43 % of biologics patients were female). However, a sharp drop in the prescription of biologics for elderly patients is present (5,8% 30-39y; 5,5%40-59y vs 3,1% 60-69; 1,74%70-79;  <0,65% 80+). In contrast to this result, patients with a disease combination receive biologics more frequently (MS+AS+PS: 29,89% vs. AS: 5,96%, PS: 2,04%, RA:9,79%). CONCLUSIONS: Although the fraction of patients with biologics increased in the last years, old people seem to be undersupplied, even though they have a higher charlson-comorbidity index. Still, this study may not clarify whether this is due to costs or patient and physician preference.