Abstract 352 A claims data analysis of regional differences in lipoprotein(a) testing in Germany

Elevated lipoprotein(a) [Lp(a)] is a cardiovascular [CV] risk factor. However, it is not commonly assessed.

The aim of the study was to evaluate Lp(a) testing patterns in the 17 associations of Statutory Health Insurance (SHI) Physicians in Germany. Patients tested were characterized by age and atherosclerotic cardiovascular disease (ASCVD) status.

A retrospective analysis was performed on data from 4 million individual patients in a national database (Institute of Applied Health Research (InGef), Berlin) that provides complete, longitudinal, anonymized claims data. The data are representative of the German population in terms of age and gender. Lp(a) billing codes documented in the ambulatory setting were used to identify adult patients in 2018 (quarter of the test = index quarter). These patients must not have had any Lp(a) test in the year prior to the index quarter. The proportion of patients tested was standardized to the number of SHI insured patients in the respective region.

In the general population, Lp(a) is tested most frequently in Brandenburg, Berlin, and Saxony (table 1). In the ASCVD population tests most frequently are conducted in Saxony, Hamburg, and Rhineland-Palatinate. Testing rates are ~3 times higher in ASCVD patients (1.04%) compared to the overall population at the national level (0.32%). In ASCVD patients, tests are performed more frequently in younger patients than in older patients.

Lp(a) tests are rarely performed in Germany and there are no apparent regional testing patterns. Current European Society of Cardiology/European Atherosclerosis Society guidelines recommend once in a lifetime testing of Lp(a) independent of prior CV events.

Table 1: Proportion of patients tested for Lp(a) standardized to the number of statutory health insurance insured people in the region in 2018

Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9
A claims data analysis of regional differences in lipoprotein(a) testing in Germany
U. Laufs¹, J. Schorr², S. Klebs³
¹Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig; ²Medical Franchise CRM & Resp, Novartis Pharma GmbH, Nürnberg; ³HE&OR, Novartis Pharma GmbH, Nürnberg;
Elevated lipoprotein(a) [Lp(a)] is a cardiovascular [CV] risk factor. However, it is not commonly assessed. The aim of the study was to evaluate Lp(a) testing patterns in the 17 associations of Statutory Health Insurance (SHI) Physicians in Germany. Patients tested were characterized by age and atherosclerotic cardiovascular disease (ASCVD) status. A retrospective analysis was performed on data from 4 million individual patients in a national database (Institute of Applied Health Research (InGef), Berlin) that provides complete, longitudinal, anonymized claims data. The data are representative of the German population in terms of age and gender. Lp(a) billing codes documented in the ambulatory setting were used to identify adult patients in 2018 (quarter of the test = index quarter). These patients must not have had any Lp(a) test in the year prior to the index quarter. The proportion of patients tested was standardized to the number of SHI insured patients in the respective region. In the general population, Lp(a) is tested most frequently in Brandenburg, Berlin, and Saxony (table 1). In the ASCVD population tests most frequently are conducted in Saxony, Hamburg, and Rhineland-Palatinate. Testing rates are ~3 times higher in ASCVD patients (1.04%) compared to the overall population at the national level (0.32%). In ASCVD patients, tests are performed more frequently in younger patients than in older patients. Lp(a) tests are rarely performed in Germany and there are no apparent regional testing patterns. Current European Society of Cardiology/European Atherosclerosis Society guidelines recommend once in a lifetime testing of Lp(a) independent of prior CV events. Table 1: Proportion of patients tested for Lp(a) standardized to the number of statutory health insurance insured people in the region in 2018
https://dgk.org/kongress_programme/ht2021/P95.htm