Epidemiology of multiple sclerosis in Germany. Regional differences and drug prescription in the claims data of the statutory health insurance

Nationwide population-based information on the prevalence of multiple sclerosis (MS) in Germany has so far not been available. In this study the prevalence of MS was determined with the help of the claims data of the health insurance funds underlying the morbidity-based risk adjustment scheme (M-RSA). Health insurance funds reported inpatient and outpatient diagnoses, outpatient prescriptions, costs and enrolment data for all persons insured in the German statutory health insurance (SHI). The data reported for 2010 form the basis of this study which collated data on the 12-month prevalence, prevalence related to age and gender, drug therapy, regional distribution pattern, combinations of diagnoses and hospitalization. Nearly 200,000 people insured in the SHI have been diagnosed with MS. Hence, the prevalence seems to be considerably higher than was previously assumed. In addition, a slight west-east gradient was apparent. On average 49 % of all MS patients (with a slight east-west gradient) received MS-specific inpatient drug therapy. Insured patients living in the east received on average 30 daily doses per year less than patients living in the western part. For the first time MS prevalence has been determined nationwide for Germany with the help of SHI data. It appears that previously applied methods have underestimated the prevalence. The regional differences found with respect to prevalence and drug therapy need further clarification. The data underlying the M-RSA do not allow more causal research.