Direct and Indirect Costs of Refractory Epilepsy in a Tertiary Epilepsy Center in Germany

Hamer, Hajo M.; Spottke, Annika; Aletsee, C.; Knake, Susanne; Reis, Janine; Strzelczyk, Adam; Oertel, Wolfgang H.; Rosenow, Felix; Dodel, Richard

doi:10.1111/j.1528-1167.2006.00889.x

Cited by 105 publications

(89 citation statements)

References 28 publications

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“…Therefore, they tend to overestimate costs. However, the use of fees as an approximation for outpatient costs is feasible in cost-ofillness analysis and has been applied in a number of previous studies [13,20,42]. Number of outpatient consultations, therapies and diagnostic procedures documented in patient diaries was multiplied by corresponding prices in the German doctor's fee scale.…”

Section: Direct Costsmentioning

confidence: 99%

“…national statistics), bottom-up approach consists of identifying and costing the resources used by individual patients [28]. At baseline, patients and their caregivers received a questionnaire [13,34,42] covering all diseaserelated expenditures during the 12 months preceding inclusion in the study. This time period was chosen to cover infrequent disease-related expenditures, such as special equipment, hospitalisations and treatment in rehabilitation clinics.…”

Section: Cost Assessmentmentioning

confidence: 99%

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Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy

et al. 2009

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Neuromuscular disorders (NMD) are chronic devastating diseases. The aim of this multicenter cross-sectional study was to evaluate the socioeconomic impact of three NMDs in Germany. Patients (n = 107) with amyotrophic lateral sclerosis (ALS), myasthenia gravis (MG) or facioscapulohumeral muscular dystrophy (FSHD) were recruited consecutively in seven centers in Germany. The health-economic data were collected using a "bottom-up" approach consisting of comprehensive questionnaires and patient diaries. Costs were evaluated from the societal perspective in 2009 Euros (EUR). Total annual costs from the societal perspective were EUR 36,380 (95% CI 27,090-47,970) per patient in ALS, EUR 26,240 (95% CI 17,770-37,940) in FSHD and EUR 14,950 (95% CI 10,470-21,730) in MG. The main components of costs were the expenditures of health insurance and the loss of productivity of patients and their caregivers. The following independent cost-driving factors were identified: disease severity, assistance in activities of daily living (ADL), dementia and younger age in ALS, disease severity in FSHD and assistance in ADL, disease severity and assistance in ADL in MG. The socioeconomic burden of NMDs in Germany is considerable. Further studies evaluating both the health-economic and clinical effects of NMD treatment as well as disease management programs and benchmarking activities are necessary.

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Section: Direct Costsmentioning

confidence: 99%

Section: Cost Assessmentmentioning

confidence: 99%

Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy

et al. 2009

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“…A validated cost questionnaire was adapted specifically for this study [27,28]. Data were calculated from the societal perspective, including costs for the patient and for the Statutory Health Insurance (Gesetzliche Krankenversicherung, GKV).…”

Section: Methodsmentioning

confidence: 99%

Economic Burden in a German Cohort of Patients with Multiple Sclerosis

Reese

John²,

Wienemann³

et al. 2011

Eur Neurol

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Aims: To estimate costs of multiple sclerosis (MS) in a German cohort according to severity of the disease and clinical symptoms. Methods: 144 patients were recruited from an MS outpatient clinic. Costs were calculated according to current German health-economic guidelines from the perspective of the social health insurance system. Patients were either interviewed or completed a questionnaire. Cost assessment covered a 3-month period. Health outcomes were: Expanded Disability Status Scale, MS Functional Composite, Functional Assessment of MS, fatigue, depression (Beck Depression Inventory II) and patients’ socioeconomic status. Multivariate linear regression identified independent cost predictors. Results: Total quarterly costs per patient were EUR 10,329 (95% CI 9,357–11,390). Direct costs were EUR 5,344 for the social health insurance system and EUR 140 for the patient. Drugs represented the major share of direct costs (and 35% of total costs); indirect costs accounted for 47% of total costs. Univariate and multivariate analyses identified age, disability, fatigue and depression as independent predictors for total, indirect or drug costs. Conclusion: MS represents a high economic burden, with direct costs exceeding indirect costs. To reduce costs, research should focus on prevention that slows down progression of MS. Rehabilitation and symptomatic treatment may have merits in decreasing indirect costs.

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“…Compared to other neurological diseases which also occur in younger patients, significant differences can be observed: a cost study in epilepsy measured direct cost of about 1,000€ and indirect costs of about 2,600€ [11]. Similar to GTS, the indirect costs largely exceed direct costs.…”

Section: Discussionmentioning

confidence: 96%

Cost of illness in patients with Gilles de la Tourette’s syndrome

et al. 2010

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We evaluated the health economic burden of patients with Gilles de la Tourette's syndrome (GTS) in Germany over a 3-month observation period. Direct and indirect costs were evaluated in 200 outpatients with GTS (mean age 35 +/- 11.5 years) in Germany. Patients were recruited from three outpatient departments that specialized in GTS and completed a semi-structured and self-rating interview with questionnaires screening for direct and indirect medical and non-medical costs, health status, depression, amount and severity of symptoms. Costs were obtained from various German medical economic resources. Indirect costs for lost productivity were calculated using the human capital approach. Costs were calculated from the point of view of healthcare and transfer payment providers and the individual patient. Multivariate regression analyses were performed to identify independent cost predictors. Costs are in year 2006-2007 values. Direct costs were 620 +/- 1,697.1euro, including rehabilitation 98.8 +/- 993.6euro, hospitalization 195.8 +/- 1,267.8euro, outpatient treatment 14.0 +/- 40.6euro, ancillary treatment 51.9 +/- 137.4euro. Drug costs were 223.1 +/- 430.4. The indirect medical costs amounted to 2,511.3 +/- 3,809.5euro for productivity loss and to 220.0 +/- 1,092euro for absenteeism. The following variables were found to impact on direct costs: employment status, occupational advancement, depression, quality of life, age. Disease severity had no influence on cost. Because of the earlier age of disease onset, indirect costs are higher than direct costs. Interestingly, disease severity did not influence the resource need in this population. Unfortunately, no cost of illness studies are available for comparison. Further health economic studies, especially cost-effectiveness studies, are necessary for a basis for rational resource allocation.

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Direct and Indirect Costs of Refractory Epilepsy in a Tertiary Epilepsy Center in Germany

Cited by 105 publications

References 28 publications

Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy

Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy

Economic Burden in a German Cohort of Patients with Multiple Sclerosis

Cost of illness in patients with Gilles de la Tourette’s syndrome

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