Endocrine Abstracts

There are no epidemiological data of Addison’s disease in Germany. Since there is no national registry for this rare disease alternative data sources need to be retrieved. The Technikerkrankenkasse (TK) is one of the large German health care insurance providers covering nearly 10% of the population. Documentation of diagnoses by all members with a doctor contact is evaluated by a scientific institute (WINEG). Screening of the database for Addison’s disease was designed to filter out all causes of secondary, iatrogenic, traumatic or other non-idiopathic forms of primary adrenal failure. The prevalence of Addison’s disease was found to range between 100 and 129 per million and showed a steady increase over the five years 2007–2011 of 22.5%. The prevalence was lower in men (73–90 per million, increase 18.9%) than in women (129–169 per million, increase 23.7%). Autoimmune comorbidities were found in 58.4%. Prevalence data for the more frequent autoimmune diseases type 1 diabetes mellitus and vitiligo did not change significantly over the years 2008–2011. These data provide a first epidemiological profile of this rare endocrine disease in Germany. Although the prevalence of Addison’s disease appears slightly lower than in the Scandinavian countries, the increasing figures particularly in females warrant further investigation into causes and triggers of autoimmune adrenal destruction. Hereby we can show that health insurance data provide a valuable tool for epidemiological studies in the absence of national registries and allow providers to improve resource allocation and management of rare and also more common chronic diseases.