Klussmann Jens P, Schädlich Peter K, Chen Xiaoyu, Rémy Vanessa
Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen.
Clinicoecon Outcomes Res. 2013 May 16;5:203-13. doi: 10.2147/CEOR.S43393. Print 2013.
Data on the economic burden of head and neck cancers (HNCs) in Germany is scarce. About 16%-28% of these cancers are associated with human papillomavirus (HPV) infection. Therefore, the study reported here aimed to assess the annual costs of HPV-related HNCs incurred by hospitalization, inpatient rehabilitation, and sick leave in Germany in 2008.
A cross-sectional retrospective analysis of five German databases covering hospital treatment, inpatient rehabilitation, and sick leave in 2008 was performed. All hospital, inpatient rehabilitation, and sick leave cases due to HNCs in 2008 were analyzed. Associated numbers of HNC hospitalizations, health care resource use, and costs were identified and extracted using the International Classification of Diseases, tenth revision (ICD-10; World Health Organization, Geneva, 1990) codes C01-C06, C09-C14, and C32 as the main diagnoses. Resources were valued with German official prices in 2008 euros (€). The annual costs of HPV-related HNCs were estimated based on the percentage of HNCs likely to be attributable to HPV infection.
In 2008, there were 63,857 hospitalizations, 4898 inpatient rehabilitations, and 17,494 sick leaves due to HNCs, representing costs of €365.78 million. The estimated annual costs associated with HPV-related HNCs were €78.22 million, mainly attributed to males (80%). Direct costs accounted for 84% (80% for hospital treatment, 4% for inpatient rehabilitation) and indirect costs due to sick leave accounted for 16% of HPV-related HNC costs.
The economic burden of HPV-related HNCs in Germany in 2008 has been underestimated, since costs incurred by outpatient management, outpatient chemotherapy, long-term care, premature retirement, and premature death were not included. However, as far as we are aware, this study is the first analysis to investigate the economic burden of HNCs in Germany. The estimated annual costs of HPV-related HNCs contribute to a significant economic burden in Germany and should be considered when assessing the health and economic benefits of HPV vaccination in both sexes.
德国头颈部癌症（HNC）经济负担的数据稀缺。这些癌症中约16%-28%与人乳头瘤病毒（HPV）感染相关。因此，本文报告的研究旨在评估2008年德国因住院、住院康复和病假产生的HPV相关HNC的年度成本。
对涵盖2008年医院治疗、住院康复和病假情况的五个德国数据库进行横断面回顾性分析。分析了2008年所有因HNC导致的医院、住院康复和病假病例。使用国际疾病分类第十版（ICD-10；世界卫生组织，日内瓦，1990）编码C01-C06、C09-C14和C32作为主要诊断，确定并提取相关的HNC住院次数、医疗资源使用情况和成本。资源按2008年欧元（€）的德国官方价格估值。基于可能归因于HPV感染的HNC百分比估算HPV相关HNC的年度成本。
2008年，因HNC导致63857次住院、4898次住院康复和17494次病假，成本达3.6578亿欧元。与HPV相关HNC相关的估计年度成本为7822万欧元，主要归因于男性（80%）。直接成本占84%（医院治疗占80%，住院康复占4%），病假导致的间接成本占HPV相关HNC成本的16%。
2008年德国HPV相关HNC的经济负担被低估了，因为未包括门诊管理、门诊化疗、长期护理、提前退休和过早死亡产生的成本。然而，据我们所知，本研究是首次对德国HNC经济负担进行的分析。HPV相关HNC的估计年度成本给德国带来了重大经济负担，在评估男女HPV疫苗接种的健康和经济效益时应予以考虑。
