HIV Insight: Antiretroviral Therapy for HIV/AIDS in Claims Data from Statutory Health Insurance Funds in Germany

The objective of this study is to determine the number of patients who receive anti-retroviral medicinal products (ARMs) and to assess the frequency of prescriptions depending on age, gender and treatment regimen by evaluating German statutory health insurance data.

We analysed a number of databases of several million customers of various nationwide statutory sickness funds and extrapolated the results to the overall population of the statutory health insurance. The number of HIV-positive patients with ARMs varied considerably between the statutory sickness funds analysed.

The number of patients with HIV diagnosis receiving ARMs that are exclusively approved for HIV increased from about

23,262 in 2008 to
30,200 in 2010.

For ARMs labelled for both, HIV and HIV/chronic hepatitis B, indications, we calculated about 34,032 patients for the year 2011.
In about 24.2% of the cases with HIV-only and HIV plus HIV/chronic hepatitis B-approved ARMs no HIV-diagnosis was documented.
Patients in this group were significantly younger and more often female as compared to patients with documented HIV diagnosis who received prescriptions of ARMs.
16.5% of the patients received treatment within the label for chronic hepatitis B.
In 7.7% of the patients ARMs were used off-label for prophylaxis (10.0%), for hepatitis (65.0%) or for unknown reasons (25.0%).
Hence, the number of people under ARMs was estimated to be below the 44,000 patients calculated for statutory sickness funds patients on the basis of prescription data in 2011.
According to our analysis only 39,000 of those could have a documented HIV diagnosis

Below: Für die gesetzliche Krankenversicherung adjustiert hochgerechnete Alters- und Geschlechtsverteilung für Patienten mit dokumentierter Diagnose und ARM-Verordnungen. Krankenkassen B im Jahr 2011

Below: Verordnungshäufigkeit der ARM in Abhängigkeit von der HIV-Diagnose in Krankenkassendaten B. Anteile eingelöster Verordnungen in 1, in 2-3 oder in allen 4 Quartalen