OBJECTIVES

: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease with high burden for the patient. The goal of this analysis was to report incidence, prevalence, and treatment patterns in adult AD patients in the German statutory health insurance system.

METHODS

: Anonymised claims data were evaluated at patient level for 3.3 million insured persons in 6 different statutory health insurances (SHI). Patients for whom the ICD-10 diagnosis code L20 (AD) was applied at least twice were analysed and data on prescription patterns for AD were reported for the years 2011 to 2015. Results were then extrapolated to the overall German population.

RESULTS

: The prevalence of AD in the German adult population was 1.6-1.9% in the years 2012 to 2015. The annual incidence in this population was between 510 and 554 cases per 100,000 persons. In the survey period Q3 and Q4 2015, 44.2% of the adult population with AD diagnosis by a dermatologist received prescriptions for AD medications. Of the patients receiving prescription medications,1.6% were treated with low-potency topical glucocorticosteroids (without previous prescription of systemic therapies). Further, 46.9% had moderate or high-potency topical glucocorticosteroids or topical calcineurin inhibitors (again without previous prescription of systemic therapies). In contrast, 23.9% had current systemic therapy (systemic glucocorticosteroids, ciclosporin, methotrexate, azathioprine, mycophenolate mofetil [the last three are not indicated for AD in Germany]). Finally, 59.2% of the adult patients without prescription medicines received at least one extemporaneous preparation. In terms of additional therapies, phototherapy was reported in 2.0% of patients.

CONCLUSIONS

: The AD prevalence estimate derived from the German statutory health insurance system is in the range of previous reports (1.35 - 4%) that used different methodologies. Based on treatment proxy, it appears that almost a quarter of treated AD patients have a severe form of AD which requires treatment with systemic therapies.