Kosten der Colitis ulcerosa – eine Kalkulation aus der Perspektive der Gesetzlichen Krankenversicherung

Prenzler, Anne; Bokemeyer, Bernd; Mittendorf, Thomas; Schulenburg, JM von der

doi:10.1055/s-0029-1244848

Cited by 10 publications

(20 citation statements)

References 13 publications

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“…Treatment for frequently relapsing patients can include oral immunosuppressants or TNF-alpha-inhibiting agents which were not included in the model. However, TNF do not play an important role in the treatment of UC-patients in Germany yet [21]; furthermore, there is no valid data with respect to transition probabilities which could have been included in the model. The inclusion of TNF therapy would probably not have an effect on the original aim of the study (comparison of Asacol and Mezavant) because the population receiving such therapy is very small and both drugs were given the same treatment pathways in the model.…”

Section: Discussionmentioning

confidence: 99%

“…Resource use and costs were determined from published results of a large cross sectional study of patients with UC in Germany [21]. Within this study, 519 patients with UC from 24 ambulatory gastroenterological specialists' practices and two hospitals were enrolled.…”

Section: Methodsmentioning

confidence: 99%

“…For this, the current German guideline [22] for the identification and valuation of resource usage was applied to evaluate the costs from the perspective of the SHI. The price year which was used in the UC-study [21] was 2007. For this present cost effectiveness analysis, the resource use collected in the cross sectional study was re-fitted to 2009 from the perspective of the German SHI on the basis of the current reimbursement practice.…”

Section: Methodsmentioning

confidence: 99%

“…To follow a conservative approach, these costs were fit to the cycle length (18.90 · 8/13 = 11.63 Euro). Furthermore, the above mentioned German UC-study [21] documented the type and amount of outpatient procedures for active UC-patients (e.g. colonoscopy, ultrasonography).…”

Section: Methodsmentioning

confidence: 99%

“…The DRGs which were chosen for this analysis were obtained from the German cost study [21] and fitted to 2009. Hence, an inpatient stay without surgery was reimbursed with 1,584.27 Euro, an inpatient stay including surgery with 3,812.55 Euro from the perspective of German SHI (again also taking co-payments by patients into account) [24].…”

Section: Methodsmentioning

confidence: 99%

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Cost effectiveness of ulcerative colitis treatment in Germany: a comparison of two oral formulations of mesalazine

Prenzler

Yen

Mittendorf

et al. 2011

BMC Health Serv Res

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BackgroundThe treatment of ulcerative colitis (UC) can place a substantial financial burden on healthcare systems. The anti-inflammatory compound 5-aminosalicylic acid (5-ASA; mesalazine) is the recommended first-line treatment for patients with UC. In this analysis, the incremental cost effectiveness ratio (ICER) of two oral formulations of 5-ASA (Mezavant® and Asacol®) is examined in the treatment of patients with mild-to-moderate, active UC in Germany.MethodsA Markov cohort model was developed to assess the cost effectiveness of Mezavant compared with Asacol over a 5-year period in the German Statutory Health Insurance (SHI). Drug pricing details for 2009 were applied throughout the model, and overall resource use was determined and also fitted to 2009 from published results of a large cross sectional study of German SHI patients. Cost per quality adjusted life year (QALY) was the primary endpoint for this study. Remission rates were obtained using data from a randomised, phase III trial of Mezavant with an active Asacol reference arm and a long-term, open label, safety and tolerability trial of Mezavant. Uncertainty in the study model was assessed using one-way and probabilistic sensitivity analyses applying a Monte Carlo simulation.ResultsOver a 5-year period, healthcare costs for patients receiving Mezavant were 624 Euro lower than for patients receiving Asacol. Additionally, patients receiving Mezavant gained 0.011 QALYs or 18 more days in remission compared with Asacol. One-way sensitivity analyses suggest that these results are driven by both differences in the acquisition cost between mesalazine formulations and differences in treatment efficacy. Furthermore, sensitivity analyses suggest a probability of 76% for cost savings and higher QALYs with Mezavant compared with Asacol. If adherence and its influence on the remission rates and the risk of developing colorectal cancer were included in the model, the results might have even been more favorable to Mezavant due to its once daily dosing regimen.ConclusionsThis model suggests that patients treated with Mezavant may achieve increased time in remission and higher QALYs, with lower direct costs to the SHI when compared with Asacol. Mezavant may therefore be a suitable first-line option for the induction and maintenance of remission in UC.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%