PREVALENCE OF PULMONARY HYPERTENSION IN GERMANY – ESTIMATIONS BASED ON A TOP-DOWN APPROACH
Author(s)
Birgit Ehlken, MSc, Project Manager1, Carlotta Plesnila-Frank, MSc, Project Manager1, H Ardeschir Ghofrani, MD, PhD, Senior Physician2, Friedrich Grimminger, MD, PhD, Head of Department2, Marius M Hoeper, MD, PhD, Senior Physician3, Gerd Stähler, MD, Senior Physician4, Heinrike Wilkens, MD, PhD, Senior Physician5, Karin Berger, MSc, Managing Director1, Ansgar Resch, MD, MPH, Group Leader61MERG-Medical Economics Research Group, Munich, Germany; 2 University Hospital Giessen and Marburg, Giessen, Germany; 3 Hannover Medical School, Hanover, Germany; 4 Klinik Löwenstein, Löwenstein, Germany; 5 University Hospitals of the Saarland, Homburg/Saar, Germany; 6 Pfizer Deutschland GmbH, Karlsruhe, Germany
OBJECTIVES: To evaluate the prevalence of pulmonary hypertension (PH) in Germany as epidemiological data for PH are lacking. METHODS: The study followed a top-down approach, based on German secondary statistics (based on ICD-10 codes) and published literature. Several secondary statistics were taken into account: Official German statistics on nationwide mortality rates, ADT (“AbrechnungsDatenTransfer”) panel data from ‘Zentralinstitut für die kassenärztliche Versorgung', and diagnosis statistics from IMS Health. Data on prevalence of PH related to connective tissue diseases, HIV infection, chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea syndrome (OSAS), left ventricular systolic dysfunction (LVSD) and pulmonary embolism (PE) were extracted from published literature 1990 to 2006 (peer-reviewed journals). Numbers of PH cases were extrapolated for Germany, based on prevalence data for the underlying diseases. RESULTS: Based on secondary statistics, number of cases in 2002 with idiopathic pulmonary arterial hypertension (ICD I27.0) ranged from 1,400 to almost 2,900 cases, and number of cases with unspecific pulmonary heart disease (ICD 27.9) ranges from 1,700 up to 10,400 cases. Based on literature data, prevalence of PH in patients with diseases like connective tissue diseases or HIV infection ranges between 2,480 and 11,160 cases. PH caused by LVSD affects about 380,000 patients. Cases of PH associated with COPD, OSAS or PE range from 191,160 to 496,320. Summing up, between 574,100 and 889,900 patients were estimated to be affected by PH. CONCLUSION: The presented analysis is the first robust estimation of the prevalence of PH for Germany. Although the subgroup of pulmonary arterial hypertension (WHO Group I) is shown to be rare, secondary forms with estimated 570,000 to 900,000 patients affected by PH should be considered of relevance in regard to socioeconomic aspects. With respect to these numbers the medical community should focus on structural aspects of care for patients with this severe disease.
Conference/Value in Health Info
2006-10, ISPOR Europe 2006, Copenhagen, Denmark
Value in Health, Vol. 9, No.6 (November/December 2006)
Code
PRS10
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Health Care Research
Disease
Respiratory-Related Disorders
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