Prevalence of psoriatic arthritis and costs generated by treatment of psoriatic arthritis patients in the public health system – the case of Poland

Abstract

ObjectiveThe objective of the study was to analyse the prevalence of psoriatic arthritis (PsA) in Poland and to assess the costs generated by treatment of PsA patients in the system of public healthcare.Material and methodsThe analysis was based on the database of the public payer, the National Health Fund (NFZ). PsA was defined by the diagnostic ICD-10 codes M07 (Enteropathic arthropathies) and L40.5 (Psoriatic arthropathies). The estimate of the costs was based on the reports submitted to the NFZ by health service providers. The prevalence rates were calculated using the NFZ data and the population estimates from the Central Statistical Office of Poland (GUS).ResultsIn 2015, the prevalence of PsA (ICD-10: L40.5 and M07) in Poland was 3.2 per 10 000 population (3.7 in women and 2.6 in men). In 2015, nearly 7.3 thousand patients with the diagnosis of M07 and 6.3 thousand patients with the diagnosis of L40.5 received healthcare benefits. Women accounted for 60.6% of those patients. Nearly three fourths of PsA patients were aged 40 to 69 years with the median age of 54 years (56 years in women and 50 years in men). Between 2008 and 2015 the NFZ expenditure on the treatment of PsA increased from 6.6 million Polish zloty (PLN) (1.9 million EUR) to PLN 50.8 million (12.1 million EUR). In the same period, the number of PsA patients increased from 3.4 thousand to 11.9 thousand. In 2015, the mean cost of treatment per PsA patient was PLN 3.8 thousand.ConclusionsThe PsA prevalence rates estimated by the authors from the NFZ database are clearly lower than those derived from studies in other European countries, which may suggest that the actual number of PsA patients in Poland may be underestimated. Still the number of patients treated for PsA increased nearly 3.5-fold during 2008–2015, when the cost of PsA treatment rose more than 7 times.

Psoriatic arthritis – classification, diagnostic and clinical aspects

“…It occurs in 5-40% of patients suffering from psoriasis vulgaris. In 2015 PsA incidence was estimated to be at the level of 3.2/10,000 individuals [1]. Present epidemiological studies have not revealed differences in the incidence of PsA in men and women [2].…”

“…Występuje u 5-40% chorych na łuszczycę zwykłą. W 2015 roku występowanie ŁZS oszacowano na 3,2/10 000 osób [1]. Aktualne badania epidemiologiczne nie wykazały różnic w częstości zachorowań na ŁZS u mężczyzn i kobiet [2], jednak łuszczyca z zajęciem stawów kręgosłupa częściej występuje u mężczyzn, natomiast postać przypominająca reumatoidalne zapalenie stawów (RZS) u kobiet [3].…”

Trends in psoriatic arthritis epidemiology in Poland

“…M07.4, M07.5, M07.6) in years 2008–2018 and found that the number of PsA-specific codes was on average 13.18 times higher (range 11.13–16.09) as compared to IBD-specific codes. Therefore, it should be assumed that: (i) the vast majority of patients reported using the M07 code are patients with PsA; (ii) the method used in our previous study [ 11 ] caused a significant underestimation of PsA prevalence; (iii) inclusion of subjects with M07 code should not lead to a significant overestimation of PsA prevalence (vast majority of those subjects do have PsA).…”

“…In 2016, our group published a study on the PsA epidemiology in Poland [ 11 ]. The study involved the analysis of National Health Fund (NHF) database and PsA cases were defined by ICD-10 codes M07 and L40.5.…”

Epidemiology and direct costs of atopic dermatitis in Poland based on the National Health Fund register (2008–2017)

“…The study used a method of desk research, namely, secondary statistical analysis of data reported to the National Health Fund in 2008-2017. This method has been successfully used previously in the analysis of NHF data for epidemiological purposes [22][23][24][25]. The National Health Fund is a public payer which has a single-payer status for all healthcare services financed from public funds in Poland.…”