Busca R, Rott C, Pietzsch JB, Herth F. Adoption of endoscopic lung volume reduction for emphysema in Germany: utilization patterns and case volumes in the period 2010–2014. Presentation to the 2016 European Congress of the International Society for Pharmacoeconomics and Outcomes Research, Breakout Session VIII, abstract MD3.

Objectives. Endoscopic lung volume reduction (LVR) is a treatment approach that has been shown to improve functional outcomes and quality of life of selected patient groups suffering from severe emphysema. Current available endoscopic LVR treatments include endobronchial valve therapy, coil therapy, and thermoablation. Our objective was to estimate the adoption patterns of these approaches in the German healthcare system, which was among the first to adopt these technologies.

Methods. Therapy- and age-specific procedure volumes were collected from German Federal Statistics Office databases for the period 2010–2014. We computed therapy-specific and total procedure volumes and growth stratified by age groups <65, and >65 years, and in total. In addition, for valve and coil therapy, we estimated the average number of devices used per procedure and approximated the number of patients treated in 2014.

Results. In the studied period, overall endoscopic LVR procedure volumes grew from 466 to 2,629 (+464%). In 2014, valve therapy constituted 54.3%, coil therapy 41.1%, and thermoablation 4.6% of all procedures. Across therapies and studied years, approximately half of the patients were younger than 65 years of age (43.0%–51.9%). The estimated average number of valves per procedure was 2.78; 2.89; 3.08; 3.35; and 3.13 in years 2010–2014, and the estimated number of coils in the three reported years 2012–2014 was 9.29; 9.15; and 9.70 coils per procedure.

As a consequence almost 1,000 and 600 patients got access to valves and coils in 2014, respectively. Coil estimates do not consider any duplicate procedure codes, and hence might partially underestimate actual device use per procedure and number of patients treated.

Conclusions. Endoscopic lung volume reduction treatment broadens the therapeutic options in selected patients with advanced emphysema. Our analysis shows continued uptake of endoscopic LVR in Germany, with consistent treatment patterns in each of the two procedures relying on multiple devices.