Weissflog D, Matthys H, Virchow J C
Abteilung für Pneumologie, Medizinische Klinik, Albert-Ludwigs-Universität Freiburg.
Dtsch Med Wochenschr. 2001 Jul 13;126(28-29):803-8. doi: 10.1055/s-2001-15705.
Asthma bronchiale (AB) and chronic bronchitis (CB) are common chronic disorders with high rates of prevalence. We performed a cost of illness study that aimed to assess the economic burden of these disorders in Germany.
Costs were estimated in 1996. In a retrospective analysis we calculated direct and indirect costs based on secondary data from governmental institutions as well as from the pharmaceutical industry. To the best of our knowledge, this is the first study which uses data for the Federal Republic of Germany following its reunification.
Total estimated costs were DM 5.81 billion related to AB, and DM 20.17 billion related to CB. We did not include outpatient physician services in the calculation of direct costs due to a lack of adequate data. Therefore, direct costs represented only 33% and 22% of total estimated costs, respectively. The most important cost driver of direct costs were outpatient prescribed medicines, followed by hospitalization. Outpatient prescribed medicines accounted for 55% and 63% of the direct costs, respectively. Of the indirect costs of AB 43% were associated with early retirement. The largest single cost driver of indirect costs due to CB was by far loss of work, amounting to 75%.
The data suggest that therapeutic progress and cessation of smoking can provide distinctive savings of direct costs and even more of indirect costs of AB and CB.
支气管哮喘（AB）和慢性支气管炎（CB）是常见的慢性疾病，患病率很高。我们开展了一项疾病成本研究，旨在评估德国这些疾病的经济负担。
成本估算于1996年进行。在一项回顾性分析中，我们根据政府机构以及制药行业的二手数据计算了直接成本和间接成本。据我们所知，这是德国统一后首次使用德国联邦共和国数据的研究。
AB的总估算成本为58.1亿德国马克，CB的总估算成本为201.7亿德国马克。由于缺乏充分数据，我们在直接成本计算中未纳入门诊医生服务。因此，直接成本分别仅占总估算成本的33%和22%。直接成本的最重要成本驱动因素是门诊处方药，其次是住院治疗。门诊处方药分别占直接成本的55%和63%。AB间接成本的43%与提前退休有关。CB间接成本最大的单一成本驱动因素是误工，高达75%。
数据表明，治疗进展和戒烟可以显著节省AB和CB的直接成本，甚至更多的间接成本。
