OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease with a substantial socio-economic impact. Study aim was to determine healthcare resource utilization and costs of AS patients from the statutory health insurance perspective in comparison to a matched general population without AS in Germany. METHODS:

A retrospectively matched cohort analysis was conducted using the Health Risk Institute research database containing anonymized German healthcare claims. Individuals with an AS diagnosis in 2013 were directly matched (1:5) to individuals without AS by age, sex, Charlson Comorbidity Index, and hospitalizations in the previous year. All-cause healthcare resource utilization and costs, stratified by healthcare sector (inpatient, outpatient, pharmaceuticals, remedies, and devices), were analyzed for the year 2013. Differences between the two cohorts were compared using unpaired t-tests and Wilcoxon rank-sum tests. RESULTS:

In 2013, 10,208 AS patients were identified and matched to 51,040 patients without AS. In both cohorts mean age was 57 years, 39% were female, and 21% had hospitalizations. Healthcare resource utilization was significantly higher in all healthcare sectors in the AS cohort with the highest difference of 20% for remedies followed by 12% for pharmaceuticals and 6% for all-cause hospitalizations. Physical therapy sessions were performed in 31% of the AS patients vs. 15% in the matched cohort. Outpatient rheumatologists were consulted in 26% vs. 3%, orthopedists in 35% vs. 23%, radiologists in 14% vs. 10%, and dermatologists in 27% vs. 22%, respectively. Mean all-cause healthcare costs were about 2,400€ higher in the AS cohort compared to the matched cohort (4,985€ vs. 2,604€, P < 0.001). Most important cost drivers were pharmaceuticals (2,453€ vs. 752€) and hospitalizations (1,333€ vs. 1,023€). CONCLUSIONS:

Real world data from this German claims database analysis showed that AS patients have significantly higher healthcare resource utilization as well as higher mean healthcare costs in all sectors compared to the general population.