Drug supply for children with psoriasis in Germany

TY - JOUR

T1 - Drug supply for children with psoriasis in Germany

AU - Augustin, Matthias

AU - Reich, Kristian

AU - Glaeske, Gerd

AU - Kämpfe, Susann

AU - Radtke, Marc Alexander

AU - Gerdau-Heitmann, Cornelia

AU - Schicktanz, Christel

AU - Schäfer, Ines

N1 - © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

PY - 2013/8/1

Y1 - 2013/8/1

N2 - BACKGROUND: In Germany there is a lack of robust nationwide data on psoriasis therapy in children.PATIENTS AND METHODS: Secondary data from the statutory health insurance Gmnder Ersatzkasse (GEK) of the year 2009 were analyzed. Continuously insured children with psoriasis vulgaris were identified by ICD-10 codes (L 40. X). Their treatment was determined on the basis of prescriptions according to ATC code.RESULTS: 1,313 of 293,181 children and adolescents had psoriasis (0.45%). Of these, n = 651 (49.6%) received at least one medication during the observation period. Topical and systemic corticosteroids were most frequently prescribed (70.8% and 4.0% respectively). The relative frequency of prescription of systemic corticosteroids was higher in children treated by pediatricians and family physicians (by a factor of 3 and 5, respectively) than in those treated by dermatologists. Vitamin D analogs were the second most frequently prescribed drugs, used far more often by dermatologists (14.7%) than by general practitioners (1.7%) and pediatricians (0.9%).CONCLUSIONS: Drug supply for children with psoriasis in Germany appears to be inadequate. The consensus guidelines are not sufficiently considered and the use of systemic corticosteroids is still too high, even after adjustment for steroid-dependent indications. The data underline the necessity of guideline-oriented therapy and implementation of current therapeutic evidence in juvenile psoriasis.

AB - BACKGROUND: In Germany there is a lack of robust nationwide data on psoriasis therapy in children.PATIENTS AND METHODS: Secondary data from the statutory health insurance Gmnder Ersatzkasse (GEK) of the year 2009 were analyzed. Continuously insured children with psoriasis vulgaris were identified by ICD-10 codes (L 40. X). Their treatment was determined on the basis of prescriptions according to ATC code.RESULTS: 1,313 of 293,181 children and adolescents had psoriasis (0.45%). Of these, n = 651 (49.6%) received at least one medication during the observation period. Topical and systemic corticosteroids were most frequently prescribed (70.8% and 4.0% respectively). The relative frequency of prescription of systemic corticosteroids was higher in children treated by pediatricians and family physicians (by a factor of 3 and 5, respectively) than in those treated by dermatologists. Vitamin D analogs were the second most frequently prescribed drugs, used far more often by dermatologists (14.7%) than by general practitioners (1.7%) and pediatricians (0.9%).CONCLUSIONS: Drug supply for children with psoriasis in Germany appears to be inadequate. The consensus guidelines are not sufficiently considered and the use of systemic corticosteroids is still too high, even after adjustment for steroid-dependent indications. The data underline the necessity of guideline-oriented therapy and implementation of current therapeutic evidence in juvenile psoriasis.

KW - Adolescent

KW - Adrenal Cortex Hormones

KW - Child

KW - Child, Preschool

KW - Dermatologic Agents

KW - Drug Utilization Review

KW - Female

KW - Germany

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Physician's Practice Patterns

KW - Prescriptions

KW - Prevalence

KW - Psoriasis

KW - Risk Factors

KW - Vitamin D

U2 - 10.1111/ddg.12102

DO - 10.1111/ddg.12102

M3 - SCORING: Journal article

C2 - 23718227

VL - 11

SP - 751

EP - 755

JO - J DTSCH DERMATOL GES

JF - J DTSCH DERMATOL GES

SN - 1610-0379

IS - 8

ER -