INSIGHTS INTO ADHD CARE IN GERMANY BASED ON SHI CLAIMS DATA 03. March Results of the CoCA Study (Horizon 2020)

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1 03. March 2017 INSIGHTS INTO ADHD CARE IN GERMANY BASED ON SHI CLAIMS DATA Results of the CoCA Study (Horizon 2020)

2 Who are we? HGC looks back on close to 30 years of experience in the health care sector Our company Founded in 1989, acquired by the Vendus Group in 2011 Based in Düsseldorf and Berlin Consulting and specialized service offerings for Industry (pharmaceutical producers, medical technology) Service Providers (Hospitals, Medical Service Centers, Physician Networks, Care Facilities, Social Service Providers) Public Sector (State and Federal Ministries, Industry Associations, Municipal Authorities) Cross-disciplinary team from: Health Insurance Sector University-Run Clinics Health Economics / Research Market Access and HEOR Pharmaceutical and med-tech industries (Marketing, Operations, Medical Affairs) Industry Our core skills Market Access, HEOR, and integrated medical care concepts (from health-economics models value dossiers) Patient Journey in the real world for Market Access, Marketing, and Operations Innovative Commercial Models (Digital, Telemarketing and Field Management) Late-Phase Brand Optimization Healthcare Service Providers Market and Competitive Analyses, Service Portfolio Comprehensive Regional Supply Management Predictive Schedule Management Referral and Accessibility Management Public Sector Demographics and Morbidity Forecasts Municipal Healthcare Supply Solutions ( E-Doctor ) Horizon 2020 research projects Page 2

HGC is part of the Horizon 2020 CoCA Study (# 667302) 17 partners from 8 European countries and the US are involved in the CoCA study

costs and the comorbidity clusters of SUD, obesity, anxiety/mood disorders for patients with ADHD in Germany provided by the public

Cost-of-illness model (COI) to model the long-term, lifetime direct and indirect costs for patients with ADHD CoCA: Comorbid

3 HGC is part of the Horizon 2020 CoCA Study (# ) 17 partners from 8 European countries and the US are involved in the CoCA study Our work package (WP1) Research: Epidemiology and Socioeconomic impact Descriptive analyses of SHI claims data to display the direct costs and the comorbidity clusters of SUD, obesity, anxiety/mood disorders for patients with ADHD in Germany provided by the public sick fund compared to a reference group created 1:1 without an ADHD-diagnosis and adjusted by age and sex. Cost-of-illness model (COI) to model the long-term, lifetime direct and indirect costs for patients with ADHD CoCA: Comorbid Conditions of Attention Deficit / Hyperactivity Disorder Source: Page 3 SHI= statutory health insurance

4 Which know-how did we contribute to the CoCA Study? We analyzed semi-exclusive SHI* claims data regarding ADHD comorbidities and therapy management and built a COI model Seite 4 Page 4 4 million patients** 5.5% representative sample of Germany cross sectional & longitudinal SHI claims data comprise Demography age sex region Outpatient sector EBM ICD Inpatient sector DRG OPS ICD Drug prescription ATC PZN Medical aids and remedies Sickness leave days *SHI= statutory health insurance **adjusted; 24 millions patients about 6 years

5 Results of the CoCA study - Overview Results of SHI claims data analyses show increasing ADHD patient numbers and cost differences compared to reference group Cohort characteristics Patient characteristics Relative increase of number of diagnosed ADHD patients % Ratio male: female across all age groups (2014) Female n= 6586 Male n= % male 74% female Average age of ADHD patient (2014) 14,7 years 17,7 years SD:8,8 Median:13 SD:12,9 Median:13 Comorbidities Young ADHD patients suffer mainly from development disorders, while older patients suffer more often from depression compared to the reference group Prevalence in Germany in 2014 over all age groups extrapolated from database 0,67%* Biggest difference in total costs (2014) per ADHD patient compared to the reference group p.a. Costs Cost difference per multimorbid* patient with ADHD and reference group (2014) p.a. Cost difference for comorbidities per ADHD patient vs. reference (2014) SUD p.a. Obesity Mood p.a p.a. (in age group 31-50) (across all age groups) Anxiety p.a. Page 5 * Multimorbidity is defined through the occurrence of at least 2 of the defined comorbidities (SUD, Obesity, Mood Disorder, Anxiety Disorder)

6 SHI data-based integrated care programmes could be a topic for further studies in the future Based on our work we already identified a gap in ADHD care for patients, aged 18 to 30 years a starting point for care improvement Including criteria Inpatient sector Outpatient sector 1 Incident patients First contact GP 2 Transition Q1 Q2 Q3 Q4 Pediatrician E- Health To close this gap and improve care, we are currently developing a concept building upon a specialized multimodal pathway aiming at funding through Innovation Fonds Page 6

7 Do you want to learn more about HGC? Our expertise and services aim at supporting --- Decision makers in the healthcare sector and public health system Scientific Working Groups who seek health-economic support for Research Projects Stakeholders who seek expert analytics the health care market Manufacturers who seek support in market access and health economic modelling Please contact Melanie May Head of Payer Affairs & Managed Care HGC GesundheitsConsult GmbH Mörsenbroicher Weg Düsseldorf mobile: Page 7

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