Trends in Breast Pump Prescription Claims: A Nationwide Population-Based Study of Outpatient Statutory Health Insurance Billing Data in Germany, 2011 to 2024

This nationwide population-based study of German statutory health insurance data from 2011 to 2024 reveals a significant 2.57-fold increase in electric breast pump prescription claims, highlighting their growing role as essential medical devices for outpatient human milk expression across the country.

The Gist

Imagine Germany's healthcare system as a massive, bustling train station. Every year, thousands of new passengers (babies) arrive, and their families need specific tools to navigate their journey. One of the most important tools on this platform is the breast pump, a device that helps parents express milk.

This study acts like a giant, high-tech surveillance camera that has been watching this train station for 13 years (from 2011 to 2024). Instead of just counting heads, the researchers looked at the "tickets" (insurance claims) people bought to rent or buy these pumps. Because they had access to data covering nearly 90% of the country, they could see the whole picture, not just a few isolated stops.

Here is what they found, translated into everyday terms:

1. The "Electric" vs. "Manual" Showdown
Think of breast pumps like cars. You have the manual pumps, which are like old-fashioned bicycles—you have to pedal them yourself to get the job done. Then you have the electric pumps, which are like modern, automatic cars with power steering.
The study found that while a tiny handful of people still ride the "bicycles" (manual pumps), almost everyone is driving the "automatic cars" (electric pumps). In fact, the electric pumps are so popular that the insurance system spent €15.3 million just on renting them out! The manual pumps were so rare in 2024 that they only cost about €27,000 total—a drop in the bucket compared to the electric ones.

2. The Explosion in Popularity
If you look back at the train station in 2011, you would see a steady stream of people asking for electric pumps. Fast forward to 2024, and that stream has turned into a roaring river.
The number of people claiming these pumps didn't just grow a little; it more than doubled (specifically, it went up by 2.57 times). To put it in perspective, for every 1,000 new babies, the number of parents getting a pump jumped from about 235 to over 600. That's an average growth of about 8% every single year, like a snowball rolling down a hill and getting bigger and bigger.

3. A Patchwork Quilt Across the Country
Germany is made up of different states, kind of like different neighborhoods in a giant city. The study noticed that some neighborhoods were much busier than others. Some states had way more pump claims than others, creating a patchwork quilt of usage across the country. However, despite these local differences, the overall trend was clear: everywhere, more parents are using these devices.

The Bottom Line
This is the first time anyone has taken a wide-angle photo of how German parents are using breast pumps over the last decade. The big takeaway? Electric breast pumps have become a standard, essential tool in the modern parenting toolkit, much like a stroller or a car seat. They are no longer a luxury; they are a common, widely supported part of caring for a newborn, and their use is growing rapidly across the nation.

Technical Summary

Study Overview

Title: Trends in Breast Pump Prescription Claims: A Nationwide Population-Based Study of Outpatient Statutory Health Insurance Billing Data in Germany, 2011 to 2024

1. Problem Statement

Despite the recognized importance of breast pumps as medical devices for supporting human milk expression, there has been a lack of epidemiological data regarding their utilization within the German healthcare system. Specifically, there was no comprehensive analysis of temporal trends, regional disparities, or the specific types of pumps (electric vs. manual) covered by statutory health insurance (SHI) in Germany. This study aims to fill that gap by analyzing prescription claims over a 13-year period to understand the scale and evolution of breast pump usage.

2. Methodology

The researchers conducted a nationwide secondary analysis utilizing a robust, multi-step data processing framework:

• Data Source: Outpatient statutory health insurance billing data from community pharmacies, covering nearly 90% of the German population from 2011 to 2024.
• Data Scaling & Extrapolation: To achieve full national coverage, raw billing data were scaled using regional extrapolation factors.
• Normalization: The scaled data were linked with national and state-level live birth statistics. This allowed for the adjustment of claims based on birth rates and population size across different federal states, ensuring comparability.
• Device Characterization: A specific list of breast pumps covered by German national SHI funds was queried to categorize devices by type (e.g., electric vs. manual) and cost characteristics.
• Metrics: The primary outcome measures included the number of claims per 1,000 infants newly enrolled in SHI and the total financial expenditure on pump rentals and dispenses.

3. Key Contributions

• First-of-its-Kind Analysis: This represents the first epidemiological analysis of statutory health insurance prescription claims specifically for breast pumps in Germany.
• Longitudinal Scope: The study provides a unique 13-year longitudinal view (2011–2024), capturing long-term trends rather than a snapshot.
• Granular Regional Data: By linking claims to state-level birth statistics, the study offers insights into regional disparities in access and utilization across German federal states.
• Device-Specific Breakdown: It distinguishes between the utilization and costs of electric versus manual pumps, providing clarity on the types of medical devices driving the market.

4. Key Results

• Dominance of Electric Pumps: Electric pumps are the primary device type covered by SHI. In 2024, national funds covered €15.3 million for electric pump rentals.
• Negligible Manual Pump Usage: In contrast, manual pumps dispensed through community pharmacies accounted for only €27,000 in 2024, indicating a minimal market share compared to electric devices.
• Significant Growth Trend: Between 2011 and 2024, the volume of electric pump claims increased by a factor of 2.57.
  • Rate Increase: Claims rose from 235.4 to 605.2 per 1,000 infants newly enrolled in SHI.
  • Growth Rate: This represents an average annual growth rate of 8.24%.
• Regional Variability: While the overall trend is upward, there are substantial variations in claim volumes across different federal states.

5. Significance

This study establishes that breast pumps, particularly electric models, have become common and critical medical devices within the German outpatient healthcare system. The substantial increase in prescription claims over the last decade suggests a shifting paradigm in postpartum care, likely driven by increased awareness, policy changes, or improved access to SHI coverage. The findings provide a baseline for policymakers and healthcare administrators to evaluate the efficiency of current reimbursement structures and to plan for future resource allocation in maternal and infant health support.