New insights into the epidemiology of ANCA-associated vasculitides in Germany: results from a claims data study.

OBJECTIVE: ANCA-associated vasculitides (AAV) are rare, potentially life-threatening autoimmune diseases characterized by systemic inflammation and organ damage. AAV prevalence rates reported in Europe vary considerably and robust data sources are often lacking. This study aimed to examine the feasibility of claims data analysis as a complementary method to registry-based studies to assess the epidemiology of AAV. METHODS: In this retrospective observational study, anonymized longitudinal claims data from years 2013-2016 from German statutory health insurance companies (data source: InGef, Institute for Applied Health Research) have been analysed on an age- and gender-stratified cohort of ∼3 million persons representative of the German population. In this cohort, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients were identified. RESULTS: The study cohort revealed a prevalence for GPA and MPA of 210 and 46 cases per million people, respectively. The annual incidence comprised 34 GPA cases and 13 MPA cases per million people per year. Hence, 17 500 AAV patients (GPA and MPA) are estimated to live in Germany, with an annual increase of 3200 patients. According to their demographic and disease-specific characteristics, AAV patients identified in this claims data approach are representative. CONCLUSION: This is the first study using claims data to assess the epidemiology of AAV. In Germany, AAV was diagnosed more frequently than it was estimated by previous self-reporting registry-based studies. The findings indicate that epidemiological data of AAV may have been underestimated but may also reflect improved diagnostic methods and disease recognition.

[Cost reductions and their effects on drug research]. / Kostendämpfung und ihre Auswirkungen auf die Arzneimittelforschung.

There are numerous reasons for the decline in pharmaceutical R and D in Germany. To mention the most important: inadequate public sponsoring of R and D activities and the late onset of biotechnology support. Cost containment in drug spending is also a major hurdle for R and D investments. An overview for the time span from 1992 to 2001, initiated by the OECD organization, reveals that average price increases for drugs in Germany are at their lowest levels as compared to other markets such as Canada, the USA, Australia and the remaining European markets. In addition, R and D productivity has, in general, decreased. Independent of locations and despite the use of new technologies, it has even worsened. This situation has not changed through the introduction of biotech products. For Germany, it is recommended to increase the investment in R and D, in order to reduce bureaucratic overheads and to better estimate innovation.