Health economic evaluations based on routine data in Germany: a systematic review

Abstract

BackgroundImproved data access and funding for health services research have promoted the application of routine data to measure costs and effects of interventions within the German health care system. Following the trend towards real world evidence, this review aims to evaluate the status and quality of health economic evaluations based on routine data in Germany.MethodsTo identify relevant economic evaluations, a systematic literature search in the databases PubMed and EMBASE was complemented by a manual search. The included studies had to be full economic evaluations using German routine data to measure either costs, effects, or both. Study characteristics were assessed with a structured template. Additionally, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) were used to measure quality of reporting.ResultsIn total, 912 records were identified and 35 studies were included in the further analysis. The majority of these studies was published in the past 5 years (n = 27, 77.1%) and used insurance claims data as a source of routine data (n = 30, 85.7%). The most common method used for handling selection bias was propensity score matching. With regard to the reporting quality, 42.9% (n = 15) of the studies satisfied at least 80% of the criteria on the CHEERS checklist.ConclusionsThis review confirms that routine data has become an increasingly common data source for health economic evaluations in Germany. While most studies addressed the application of routine data, this analysis reveals deficits in considering methodological particularities and in reporting quality of economic evaluations based on routine data. Nevertheless, this review demonstrates the overall potential of routine data for economic evaluations.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3080-3) contains supplementary material, which is available to authorized users.

Economic Evaluations Informed Exclusively by Real World Data: A Systematic Review

“…Gansen [111] found that the principal illnesses assessed were cardiovascular diseases followed by type II diabetes mellitus whereas neoplasms were the main focus of evaluation in our review. This may be due to the fact that Gansen [111] only reviewed studies performed in Germany.…”

“…A systematic review of the use of RWD for EE in Germany was identified [111] and some comparisons with this are presented below. However, some inclusion criteria differ from those of the present study, such as studies that use routine data as a source of information for costs or effects or both.…”

“…Our review includes studies that use RWD in costs and effects. Moreover, Gansen [111] only included studies based on data from Germany and the authors put no restrictions on the publication language while, in contrast, we placed no restrictions on specific country databases but did restrict the publication languages.…”

Real-World Treatment of Patients with Multiple Sclerosis per MS Subtype and Associated Healthcare Resource Use: An Analysis Based on 13,333 Patients in Germany

“…Additionally, it needs to be noted that a bottom-up approach could have potentially provided more accurate cost estimates than the top-down approach used in our analysis. However, claims data are a comprehensive and reliable basis that have become an important data source for health economic evaluations [41,42]. Furthermore, we only analyzed filled prescriptions in our database.…”

Standardisierte Kostenberechnungen im deutschen Gesundheitswesen: Bericht der Arbeitsgruppe „Standardkosten“ des Ausschusses „ökonomische Evaluation“ der dggö

“…In den nachfolgenden Sektor-spezifischen Artikeln sollen deshalb getrennte Vorgehensweisen zu primärdaten-, sekundärdaten-oder listenbasiertem Costing beschrieben werden. In diesem Zusammenhang ist auch eine Zunahme von Kostenberechnungen mit Hilfe von GKV-Routinedaten zu beobachten, die zumindest bei einer GKV-Perspektive die Probleme der oben genannten Studiendesigns teilweise lösen können, obschon sie auch eigene Unsicherheiten mit sich bringen [15], [16]. Der Besonderheit dieser Art der Kostenberechnung soll in einem gesonderten (sechsten) Artikel Rechnung getragen werden.…”