Schley Katharina, Heinrich Kirstin, Moïsi Jennifer C, Häckl Dennis, Obermüller Dominik, Brestrich Gordon, von Eiff Christof, Weinke Thomas
Pfizer Pharma GmbH, Friedrichstrasse 110, 10117, Berlin, Germany.
Pfizer Inc., Patient and Health Impact, New York, NY, 10017, USA.
Infect Dis Ther. 2025 Jan;14(1):91-104. doi: 10.1007/s40121-024-01075-1. Epub 2024 Nov 20.
Health claims data are a valuable resource for health services research, enabling analysis of the costs of hospitalizations, outpatient visits, procedures, and medications, and providing an improved understanding of the economic burden and underlying cost drivers for a given health condition. Since no recent data were available from Germany on the medical costs and clinical outcomes of Clostridioides difficile infections (CDI), this study assessed the economic burden of CDI and all-cause mortality in adults in Germany.
A retrospective cohort study was conducted using a large, anonymized administrative health claims research database from Germany from which an age- and sex-representative sample of 4 million insured persons covered by approximately 60 statutory health insurances was extracted. Propensity score matching was conducted on age, sex, comorbidities, and antibiotic use to identify four matched controls (i.e., patients without CDI) for every eligible adult patient with CDI (i.e., case) in the study cohort. Costs, healthcare resource utilization, and CDI-attributable all-cause mortality were assessed.
Overall, there were 15,342 CDI cases in the study cohort. One-year mortality in CDI cases (45.7%) was more than fourfold that of matched non-CDI controls (11.0%). In the year following the index date, average mortality-adjusted medical costs per person-time for CDI cases were almost fivefold that of matched non-CDI controls, representing a cost difference of €31,459, mainly driven by inpatient treatment. Overall excess costs for CDI cases were estimated at approximately €1.6 billion within 1 year after diagnosis.
CDI in Germany is associated with a high clinical and economic burden, including significantly higher mortality, costs, and healthcare resource utilization, in patients with CDI versus their matched patients without CDI. This has important implications for patients, healthcare providers, and the healthcare system.
健康索赔数据是健康服务研究的宝贵资源，有助于分析住院、门诊就诊、手术和药物治疗的费用，并能更好地理解特定健康状况的经济负担和潜在成本驱动因素。由于德国近期没有关于艰难梭菌感染（CDI）的医疗费用和临床结果的数据，本研究评估了德国成年人CDI的经济负担和全因死亡率。
采用一项回顾性队列研究，使用来自德国的一个大型匿名行政健康索赔研究数据库，从中提取了约60个法定健康保险覆盖的400万参保人的年龄和性别代表性样本。对年龄、性别、合并症和抗生素使用情况进行倾向得分匹配，以便为研究队列中每一位符合条件的成年CDI患者（即病例）确定四个匹配对照（即无CDI的患者）。评估了费用、医疗资源利用情况以及CDI所致的全因死亡率。
总体而言，研究队列中有15342例CDI病例。CDI病例的一年死亡率（45.7%）是匹配的非CDI对照（11.0%）的四倍多。在索引日期后的一年中，CDI病例每人次的平均死亡率调整医疗费用几乎是非CDI对照的五倍，成本差异为31459欧元，主要由住院治疗驱动。CDI病例在诊断后1年内的总体额外费用估计约为16亿欧元。
在德国，CDI与高临床和经济负担相关，包括与匹配的无CDI患者相比，CDI患者的死亡率、费用和医疗资源利用显著更高。这对患者、医疗服务提供者和医疗系统具有重要意义。
