Jacob Christian, Bechtel Benno, Engel Susanne, Kardos Peter, Linder Roland, Braun Sebastian, Greiner Wolfgang
Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
GlaxoSmithKline, Uxbridge, Greater London, UK.
Eur J Health Econ. 2016 Mar;17(2):195-201. doi: 10.1007/s10198-015-0671-3. Epub 2015 Feb 26.
Asthma is associated with a substantial economic burden on the German Statutory Health Insurance.
To determine costs and resource utilization associated with asthma and to analyze the impact of disease severity on subgroups based on age and gender.
A 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.
Overall, 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).
The 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.
哮喘给德国法定医疗保险带来了沉重的经济负担。
确定与哮喘相关的成本和资源利用情况，并分析疾病严重程度对基于年龄和性别的亚组的影响。
从法定医疗保险的角度进行了索赔数据库分析。从德国一家大型疾病基金的10%样本中提取国际疾病分类第十次修订本（ICD-10-GM）编码为哮喘的患者。从同一数据库中为每位哮喘患者随机选取5名年龄和性别匹配的对照。计算哮喘组和对照组中每个人的成本和资源利用情况。将与哮喘相关的增量成本计算为平均成本差异。根据规定的哮喘药物，将患者分为间歇性或持续性。此外，分别分析了≤5岁、6-18岁和>18岁的年龄组，并研究了性别差异。
总体而言，哮喘组纳入了49668人。与对照组相比，每位患者的年均总成本平均高出753欧元（p = 0.000）（2168欧元对1415欧元）。哮喘患者的门诊费用（217欧元）、住院费用（176欧元）和药房费用（259欧元）显著更高（p = 0.000）。与间歇性哮喘患者相比，持续性哮喘患者与哮喘相关的增量总成本更高（1091欧元对408欧元）。>18岁患有持续性哮喘的女性与对照组相比成本差异最大（1207欧元；p < 0.0001）。哮喘组相应的医疗资源利用显著更高（p = 0.000）。
哮喘治疗与医疗资源利用水平增加和医疗成本显著升高相关。哮喘给疾病基金带来了沉重的经济负担。
