Siffel Csaba, Hennies Nora, Joseph Corey, Lascano Valeria, Horvat Pia, Scheider Maria, Ganzera Frank
Takeda, Lexington, MA, USA.
College of Allied Health Sciences, Augusta University, Augusta, GA, USA.
Acta Ophthalmol. 2020 Jun;98(4):e504-e512. doi: 10.1111/aos.14300. Epub 2019 Nov 17.
To evaluate the clinical and economic burden of dry eye disease (DED) among affected patients in Germany.
Adult patients (≥18 years) with ≥1 confirmed diagnosis of DED during the study period (2008-2015) were identified from the medical claims of ~3.6 million insured patients from Betriebskrankenkassen, a German statutory health insurance database. Prevalence (per 1000 patients) and incidence (per 1000 person-years at risk) were estimated, and demographic and clinical characteristics, treatment history (excluding over-the-counter tear supplements), healthcare resource use (HCRU) and costs were assessed.
In this population, the prevalence of DED increased from 20.24 in 2008 to 23.13 per 1000 patients in 2014. Overall incidence was 6.24 per 1000 person-years at risk (2008-2015). Prevalence and incidence increased with age and were higher in women. Mean age at index was 63.4 years (incident cohort, n = 35 026). The most common ocular comorbidity was cataract (48.5%), and ~36% of patients were dispensed a reimbursed DED-specific medication during the postindex period - most commonly, corticosteroids alone (13.2%) or in combination with anti-infectives (21.8%). HCRU was high in patients with DED, mostly due to comorbidities. HCRU and associated costs were highest in patients ≥60 years. Total costs during the postindex period were higher in the DED cohort than among matched controls (€117 million versus €107 million; p < 0.001).
This retrospective database analysis provides a better understanding of the epidemiology, clinical characteristics, real-world treatment patterns, HCRU and costs associated with DED in patients living in Germany.
评估德国干眼症（DED）患者的临床和经济负担。
从德国法定医疗保险数据库 Betriebskrankenkassen 中约360万参保患者的医疗理赔记录中，识别出在研究期间（2008 - 2015年）确诊≥1次DED的成年患者（≥18岁）。估算患病率（每1000名患者）和发病率（每1000人年风险），并评估人口统计学和临床特征、治疗史（不包括非处方泪液补充剂）、医疗资源使用（HCRU）和成本。
在该人群中，DED的患病率从2008年的每1000名患者20.24例增加到2014年的23.13例。总体发病率为每1000人年风险6.24例（2008 - 2015年）。患病率和发病率随年龄增长而增加，女性更高。发病时的平均年龄为63.4岁（发病队列，n = 35026）。最常见的眼部合并症是白内障（48.5%），约36%的患者在发病后期间使用了报销的DED特异性药物 - 最常见的是单独使用皮质类固醇（13.2%）或与抗感染药联合使用（21.8%）。DED患者的HCRU较高，主要是由于合并症。60岁及以上患者的HCRU和相关成本最高。发病后期间DED队列的总成本高于匹配对照组（1.17亿欧元对1.07亿欧元；p < 0.001）。
这项回顾性数据库分析有助于更好地了解德国DED患者的流行病学、临床特征、实际治疗模式、HCRU和成本。
