title: Drug supply for children with psoriasis in Germany.
abstract: BACKGROUND
  In Germany there is a lack of robust nationwide data on psoriasis therapy in children.
  
  
  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.
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany. m.augustin@uke.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.forename: Gerd
authors.initials: G
authors.lastname: Glaeske
authors.forename: Susann
authors.initials: S
authors.lastname: Kämpfe
authors.forename: Marc Alexander
authors.initials: MA
authors.lastname: Radtke
authors.forename: Cornelia
authors.initials: C
authors.lastname: Gerdau-Heitmann
authors.forename: Christel
authors.initials: C
authors.lastname: Schicktanz
authors.forename: Ines
authors.initials: I
authors.lastname: Schäfer
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003879:Dermatologic Agents / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data*; D015995:Prevalence; D011565:Psoriasis / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; D014807:Vitamin D