Krankheitskosten für Asthma und COPD bei Erwachsenen in der Bundesrepublik Deutschland

Kirsch, F.W.; Teuner, Christina M.; Menn, Petra; Leidl, Reiner

doi:10.1055/s-0033-1333742

Cited by 21 publications

(10 citation statements)

References 11 publications

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“…A systematic review [18] of 7 COPD studies in Germany found annual costs per COPD patient between €1212 and €3492 (price year 2010) from a societal perspective. Most studies are limited to singular direct [4, 19, 20] or indirect [21] cost categories.…”

Section: Discussionmentioning

confidence: 99%

Direct and indirect costs of COPD progression and its comorbidities in a structured disease management program: results from the LQ-DMP study

et al. 2019

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Background Evidence on the economic impact of chronic obstructive pulmonary disease (COPD) for third-party payers and society based on large real world datasets are still scarce. Therefore, the aim of this study was to estimate the economic impact of COPD severity and its comorbidities, stratified by GOLD grade, on direct and indirect costs for an unselected population enrolled in the structured German Disease Management Program (DMP) for COPD. Methods All individuals enrolled in the DMP COPD were included in the analysis. Patients were only excluded if they were not insured or not enrolled in the DMP COPD the complete year before the last DMP documentation (at physician visit), had a missing forced expiratory volume in 1 s (FEV1) measurement or other missing values in covariates. The final dataset included 39,307 patients in GOLD grade 1 to 4. We used multiple generalized linear models to analyze the association of COPD severity with direct and indirect costs, while adjusting for sex, age, income, smoking status, body mass index, and comorbidities. Results More severe COPD was significantly associated with higher healthcare utilization, work absence, and premature retirement. Adjusted annual costs for GOLD grade 1 to 4 amounted to €3809 [€3691–€3935], €4284 [€4176–€4394], €5548 [€5328–€5774], and €8309 [€7583-9065] for direct costs, and €11,784 [€11,257–€12,318], €12,985 [€12,531-13,443], €15,805 [€15,034–€16,584], and €19,402 [€17,853–€21,017] for indirect costs. Comorbidities had significant additional effects on direct and indirect costs with factors ranging from 1.19 (arthritis) to 1.51 (myocardial infarction) in direct and from 1.16 (myocardial infarction) to 1.27 (cancer) in indirect costs. Conclusion The findings indicate that more severe GOLD grades in an unselected COPD population enrolled in a structured DMP are associated with tremendous additional direct and indirect costs, with comorbidities significantly increase costs. In direct cost category hospitalization and in indirect cost category premature retirement were the main cost driver. From a societal perspective prevention and interventions focusing on disease control, and slowing down disease progression and strengthening the ability to work would be beneficial in order to realize cost savings in COPD.

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Section: Discussionmentioning

confidence: 99%

Direct and indirect costs of COPD progression and its comorbidities in a structured disease management program: results from the LQ-DMP study

et al. 2019

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“…Van Muijen and colleagues [ 78 ] reviewed only cohort studies of cancer-related work outcomes and were focused on English language. Steiner and colleagues [ 76 ] reviewed English publications published up until 2003, Breton and colleagues were focused only on diabetes and Krisch and colleagues focused on COPD in Germany [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

The global impact of non-communicable diseases on macro-economic productivity: a systematic review

et al. 2015

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Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)] on macro-economic productivity. Systematic search, up to November 6th 2014, of medical databases (Medline, Embase and Google Scholar) without language restrictions. To identify additional publications, we searched the reference lists of retrieved studies and contacted authors in the field. Randomized controlled trials, cohort, case–control, cross-sectional, ecological studies and modelling studies carried out in adults (>18 years old) were included. Two independent reviewers performed all abstract and full text selection. Disagreements were resolved through consensus or consulting a third reviewer. Two independent reviewers extracted data using a predesigned data collection form. Main outcome measure was the impact of the selected NCDs on productivity, measured in DALYs, productivity costs, and labor market participation, including unemployment, return to work and sick leave. From 4542 references, 126 studies met the inclusion criteria, many of which focused on the impact of more than one NCD on productivity. Breast cancer was the most common (n = 45), followed by stroke (n = 31), COPD (n = 24), colon cancer (n = 24), DM (n = 22), lung cancer (n = 16), CVD (n = 15), cervical cancer (n = 7) and CKD (n = 2). Four studies were from the WHO African Region, 52 from the European Region, 53 from the Region of the Americas and 16 from the Western Pacific Region, one from the Eastern Mediterranean Region and none from South East Asia. We found large regional differences in DALYs attributable to NCDs but especially for cervical and lung cancer. Productivity losses in the USA ranged from 88 million US dollars (USD) for COPD to 20.9 billion USD for colon cancer. CHD costs the Australian economy 13.2 billion USD per year. People with DM, COPD and survivors of breast and especially lung cancer are at a higher risk of reduced labor market participation. Overall NCDs generate a large impact on macro-economic productivity in most WHO regions irrespective of continent and income. The absolute global impact in terms of dollars and DALYs remains an elusive challenge due to the wide heterogeneity in the included studies as well as limited information from low- and middle-income countries.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-015-0026-5) contains supplementary material, which is available to authorized users.

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“…A recent review from Kirsch et al [ 16 ] estimated annual asthma-specific costs of €445 to €2,543 per patient from the social perspective. Cost data was collected from published cost-of-illness studies and adjusted for the year 2010.…”

Section: Discussionmentioning

confidence: 99%

“…The disease also represents a constant major economic burden for the German statutory healthcare system [ 2 , 10 , 11 ] with approximately €1.789 billion in 2008, accounting for 0.7 % of the total healthcare expenditure in Germany [ 12 ]. Several studies have assessed the costs of asthma in the German setting, considering a payer’s perspective or a societal perspective [ 2 , 5 , 10 , 11 , 13 – 16 ]. Yet, further research is required as data of the available studies is fragmentary and does not include all relevant cost domains.…”

Section: Introductionmentioning

confidence: 99%

Healthcare costs and resource utilization of asthma in Germany: a claims data analysis

Jacob¹,

Bechtel

Engel

et al. 2015

Eur J Health Econ

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IntroductionAsthma is associated with a substantial economic burden on the German Statutory Health Insurance.Aims and objectivesTo determine costs and resource utilization associated with asthma and to analyze the impact of disease severity on subgroups based on age and gender.MethodsA claims database analysis from the statutory health insurance perspective was conducted. Patients with an ICD-10-GM code of asthma were extracted from a 10 % sample of a large German sickness fund. Five controls for each asthma patient matched by age and gender were randomly selected from the same database. Costs and resource utilization were calculated for each individual in the asthma and control group. Incremental asthma-related costs were calculated as the mean cost difference. Based on prescribed asthma medication, patients were classified as intermittent or persistent. In addition, age groups of ≤5, 6–18, and >18 years were analyzed separately and gender differences were investigated.ResultsOverall, 49,668 individuals were included in the asthma group. On average, total annual costs per patient were €753 higher (p = 0.000) compared to the control group (€2,168 vs. €1,415). Asthma patients had significantly higher (p = 0.000) outpatient (€217), inpatient (€176), and pharmacy costs (€259). Incremental asthma-related total costs were higher for patients with persistent asthma compared to patients with intermittent asthma (€1,091 vs. €408). Women aged >18 years with persistent asthma had the highest difference in costs compared to their controls (€1,207; p < 0.0001). Corresponding healthcare resource utilization was significantly higher in the asthma group (p = 0.000).ConclusionsThe treatment of asthma is associated with an increased level of healthcare resource utilization and significantly higher healthcare costs. Asthma imposes a substantial economic burden on sickness funds.

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Krankheitskosten für Asthma und COPD bei Erwachsenen in der Bundesrepublik Deutschland

Cited by 21 publications

References 11 publications

Direct and indirect costs of COPD progression and its comorbidities in a structured disease management program: results from the LQ-DMP study

Direct and indirect costs of COPD progression and its comorbidities in a structured disease management program: results from the LQ-DMP study

The global impact of non-communicable diseases on macro-economic productivity: a systematic review

Healthcare costs and resource utilization of asthma in Germany: a claims data analysis

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