Costs of rheumatoid arthritis in Germany: a micro-costing approach based on healthcare payer's data sources

Abstract

Objective: To develop a systematic set of German cost data in rheumatoid arthritis (RA) based solely on valid healthcare payer's cost data sources. Methods: Retrospectively one year cost data of 338 patients with RA were generated and analysed. The cost data were derived from a major statutory health insurance plan ("Allgemeine Ortskrankenkasse Niedersachsen") and the regional physicians' association ("Kassenärztliche Vereinigung Niedersachsen"). The recently published matrix of cost domains in RA was applied to structure the analysis. Descriptive statistics were used to analyse the data. Results: The total direct costs for the 338 patients during one year (third quarter 2000 to second quarter 2001) were 3815 per patient-year. RA related direct costs were 2312 per patient-year. Outpatient costs accounted for 73.7%, inpatient costs for 24.0%, and other disease related costs for 2.3% of RA related direct costs. Outpatients cost drivers were RA related drugs ( 1019 per patient-year), physician visits ( 323 per patient-year), diagnostic and therapeutic procedures and tests ( 185 per patient-year), and devices and aids ( 168 per patient-year). 98 patients were retired prematurely owing to RA related work disability and incurred costs of 8358 per retired patient-year. 96 patients were gainfully employed and incurred sick leave costs of 2835 per employed patient-year. Conclusion: Micro-costing based on healthcare payer's data provides a relatively conservative albeit highly accurate estimate of costs in RA. Both RA related and non-RA related costs must be taken into account. In gainfully employed patients and in patients who receive RA related retirement payments productivity costs exceed direct costs.

Direct costs related to rheumatoid arthritis: the patient perspective

“…7 Medication costs are by far the most important cost domain from a payer's perspective and account for J1019 per patient per year (44% of total direct rheumatoid arthritis related costs from the payer's perspective). 16 It is well known, that from a consumer perspective OOPE for medication is less dominant. 22 In our study, OOPE for medication resulted in J99 per patient and year (24% of total direct rheumatoid arthritis related costs from the patients' perspective).…”

“…A patient per patient microcosting approach was carried out. 16 N In addition, a patient questionnaire was developed and applied. 17 The questionnaire was completed by patients at baseline and then once per quarter throughout 2001.…”

Versorgungsforschung mit Routinedaten in der Onkologie

“…Apothekenrechenzentren elektronisch erfasst. Diese Informationen, die Originalrezepte und die eingescannten Belege (Images) werden anschließend an die Kassen weitergeleitet (für eine detaillierte Darstellung zum Weg des Rezepts s. [27] [39,40]. Weniger kostenaufwendig ist die Verknüpfung mit weiteren Routine-bzw.…”

Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

“…Patients also need to pay € 10 per hospital day, including drug costs, as a co-payment, but the contribution is limited to a maximum of 28 days in a calendar year [19]. The patient's co-payment is not considered part of the EBM-based accounting system for the outpatient setting [20]. Co-payments for drugs amount to 10% of the prices, but no less than € 5 and no more than € 10 per package.…”