Diel Roland, Nienhaus Albert
Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Kiel, Germany.
Lung Clinic Großhansdorf, Großhansdorf, Germany.
ERJ Open Res. 2020 Oct 26;6(4). doi: 10.1183/23120541.00329-2020. eCollection 2020 Oct.
A total of 5429 new cases of tuberculosis (TB) were reported in Germany in 2018; out of the 3780 TB cases for whom drug susceptibility testing was available, the proportion of multidrug-resistant TB (MDR-TB) cases was only 3.1% (118 cases).
On the basis of the current therapy guidelines of the German Central Committee against Tuberculosis, this study estimates the mean direct outpatient and combined in- and outpatient costs per non-MDR-TB patient from the perspective of the German statutory health insurance (SHI) system, together with costs arising from productivity losses and costs due to public health screening for TB in close contacts.
From the insurance perspective, the mean outpatient costs (rounded) per case were €1628 for adults and €1179 for children for standard therapy; the mean cost of inpatient treatment amounted to €8626. The mean combined inpatient/outpatient cost was €8756 for adults and €8512 for children. As 95% of all TB patients were adults, the weighted treatment cost per patient in Germany in 2018 was €8746. These are in addition to the mean cost arising from productivity losses (€1839) and, weighted by pulmonary infectivity, cost of contact investigations (€368), coming to a total of €10 953.
Given the clear increase in the number of non-MDR-TB cases since 2015, TB is still a disease of significant economic impact in Germany.
2018年德国共报告了5429例新发结核病病例；在3780例可进行药敏试验的结核病病例中，耐多药结核病（MDR-TB）病例的比例仅为3.1%（118例）。
基于德国结核病中央委员会的现行治疗指南，本研究从德国法定医疗保险（SHI）系统的角度估计了每位非耐多药结核病患者的平均门诊直接费用以及门诊和住院联合费用，同时还包括生产力损失产生的费用以及对密切接触者进行结核病公共卫生筛查的费用。
从保险角度来看，标准治疗的成人病例平均门诊费用（四舍五入）为1628欧元，儿童为1179欧元；住院治疗的平均费用为8626欧元。成人门诊和住院联合平均费用为8756欧元，儿童为8512欧元。由于所有结核病患者中有95%为成人，2018年德国每位患者的加权治疗费用为8746欧元。这些费用还需加上生产力损失产生的平均费用（1839欧元）以及根据肺部传染性加权的接触者调查费用（368欧元），总计10953欧元。
鉴于自2015年以来非耐多药结核病病例数量明显增加，结核病在德国仍然是一种具有重大经济影响的疾病。
