Download PDF
Nervenheilkunde 2007; 26(04): 260-268
DOI: 10.1055/s-0038-1626857
Kompetenznetz: Parkinson
Schattauer GmbH

Krankheitskosten neurologischer Erkrankungen in Deutschland

Cost-of-illness in neurological diseases in Germany
T. Walbert
2   University Hospitals Case Medical Center, Cleveland, Ohio, USA
,
J.-P. Reese
1   Klinik für Neurologie, Philipps-Universität Marburg
,
R. Dodel
1   Klinik für Neurologie, Philipps-Universität Marburg
› Author Affiliations
Further Information

Publication History

Eingegangen am: 10 January 2007

Publication Date:
19 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Ziel dieser Arbeit ist, eine systematische Übersicht deutscher Krankheitskostenstudien (KKS) neurologischer Erkrankungen vorzulegen. Krankheitskostenstudien dienen als Referenzmaßstäbe für ökonomische Analysen und liefern wichtige Informationen zur Ressourcenallokation für Entscheidungsträger im Gesundheitswesen.

Anhand einer systematischen Literaturrecherche wurden KKS neurologischer Erkrankungen identifiziert und mittels eines strukturierten Fragebogens ausgewertet.

Insgesamt entsprachen 52 Arbeiten den Suchkriterien (Multiple Sklerose 6, Schlaganfall 11, Migräne/Kopfschmerz 6, Epilepsie 4, M. Alzheimer 8, M. Parkinson 15, Dystonie 2). Für Ataxie, Schwindel, ALS und ZNS-Tumoren konnten keine KKS gefunden werden. Die Auswertung der Literatur ergab, dass für viele neurologischen Erkrankungen in Deutschland keine validen Studien zur Verfügung stehen, die das Ausmaß der ökonomischen Belastung für das Gesundheitssystem erkennen lassen würden. Die vorgestellten KKS verdeutlichen die Schwierigkeiten, Kosten, Nutzen und Ressourcenverbrauch neurologischer Erkrankungen transparent darzustellen. Diese Daten sind jedoch wichtig, um eine rationale Diskussion zur Allokation der Ressourcen führen zu können.

Summary

The aim of this work is to present a systematic review of German cost-of-illness (COI) studies of neurological diseases. COI studies serve as references for economic evaluations and provide important information to healthcare decision makers in order to allocate resources.

A systematic literature review was performed to identify COI studies of neurological diseases and information was extracted by using a standardized assessment form. We found 52 studies that matched the search criteria (multiple sclerosis 6, stroke 11, migraine/headache 6, epilepsy 4, Alzheimer’s disease 8, Parkinson’s disease 15, dystonia 2). We were not able to retrieve any COI studies for ataxia, vertigo, ALS or CNS-tumours.

Based on the literature, no valid German studies are available that would allow a detailed assessment of the economic impact of neurological diseases to society.

The reviewed COI studies emphasize the difficulties to present costs, utilities and the use of resources in a transparent way. This information, however, is important to have a rational discussion about the allocation of limited resources in the healthcare systems.

Schlüsselwörter

Kosten - Neurologie - Krankheitskostenstudie - Evidenz - Gesundheitssystem

Keywords

Cost-of-illness - neurology - cost - evidence-based - healthcare system
 

  • Literatur

  • 1 Schöffski O, v. Schulenburg JM. Gesundheitsökonomische Evaluationen. Berlin: Springer; 2000
    Search in Google Scholar
  • 2 Ekman M, Westphal M. Cost of brain tumour in Europe. Eur J Neurol 2005; 12 (Suppl. 01) 45-49.
    Search in Google Scholar
  • 3 Hein T, Hopfenmuller W. Projection of the number of multiple sclerosis patients in Germany. Nervenarzt 2000; 71 (04) 288-294.
    CrossrefPubMedSearch in Google Scholar
  • 4 Hauser S. Multiple sclerosis and other demyelinating diseases. In: Isselbacher KB, Wilson J. (ed). Harrison’s principles of internal medicine. New York: McGraw-Hill; 1994: 2281-2294.
    Search in Google Scholar
  • 5 Mayr WT, Pittock SJ, McClelland RL, Jorgensen NW, Noseworthy JH, Rodriguez M. Incidence and prevalence of multiple sclerosis in Olmsted County, Minnesota, 1985–2000. Neurology 2003; 61 (10) 1373-1377.
    CrossrefPubMedSearch in Google Scholar
  • 6 Rieckmann P. Early multiple sclerosis therapy in the effects of public health economics. Med Klinik 2001; 96 (Suppl. 01) 17-21.
    PubMedSearch in Google Scholar
  • 7 Kobelt G, Lindgren P, Smala A, Bitsch A, Haupts M, Ko M. et al. Costs and quality of life in multiple sclerosis. An observational study in Germany. Hepac Health Econ Prev Care 2001; 02 (02) 60-68.
    Search in Google Scholar
  • 8 Murphy N, Confavreux C, Haas J, Konig N, Roullet E, Sailer M. et al. Quality of life in multiple sclerosis in France, Germany, and the United Kingdom. Cost of Multiple Sclerosis Study Group. JNNP 1998; 65 (04) 460-466.
    Search in Google Scholar
  • 9 Kobelt G. et al. Cost-utility of interferon beta1b in the treatment of patients with active relapsing-remitting or secondary progressive multiple sclerosis. Eur J Health Econ 2003; Vol 04 (01) 50-59.
    CrossrefPubMedSearch in Google Scholar
  • 10 Murphy N, Confavreux C, Haas J, Konig N, Roullet E, Sailer M. et al. Economic Evaluation of Multiple Sklerosis in the UK, Germany and France. Pharmacoeconomics 1998; 05 (02) 607-622.
    Search in Google Scholar
  • 11 Heinemann LA, Barth W, Garbe E, Willich SN, Kunze K, Wiesner G. et al. Epidemiologic data of stroke. Data of the WHO-MONICA Project in Germany. Stroke: prevalence, incidence, trends, East-West comparison. Initial results of the 1998 Federal Health Survey. Nervenarzt 1998; 09 (12) 091-1099.
    Search in Google Scholar
  • 12 Reed SD, Blough DK, Meyer K, Jarvik JG. Inpatient costs, length of stay, and mortality for cerebrovascular events in community hospitals. Neurology 2001; 07 (02) 305-314.
    Search in Google Scholar
  • 13 Evers SM, Ament AJ, Blaauw G. Economic evaluation in stroke research: a systematic review. Stroke 2000; 31 (05) 1046-1053.
    CrossrefPubMedSearch in Google Scholar
  • 14 Grieve R, Hutton J, Bhalla A, Rastenyte D, Ryglewicz D, Sarti C. et al. A comparison of the costs and survival of hospital-admitted stroke patients across Europe. Stroke 2001; 32 (07) 1684-1691.
    CrossrefPubMedSearch in Google Scholar
  • 15 Weimar C, Lüngen M, Wagner M, Evers T, Busse O. et al. Kostenanalyse der Schlaganfallbehandlung in Deutschland. Akt Neurol 2002; 29: 181-190.
    Thieme ConnectSearch in Google Scholar
  • 16 Weimar C, Weber C, Wagner M, Busse O, Haberl RL, Lauterbach KW. et al. Management patterns and health care use after intracerebral hemorrhage. a cost-of-illness study from a societal perspective in Germany. Cerebrovascular Diseases 2003; 15 (1–2): 29-36.
    PubMedSearch in Google Scholar
  • 17 Dodel RC, Haacke C, Zamzow K, Pawelzik S, Spottke A, Rethfeldt M. et al. Resource Utilization and Costs of Stroke Unit Care in Germany. Value Health 2004; 07 (02) 144-152.
    CrossrefPubMedSearch in Google Scholar
  • 18 Back T, Schaeg M, Back C, Epifanov Y, Hemmen T, Dodel RC. et al. Costs of stroke unit care in Germany. Resource use and reimbursements by German diagnosis related groups. Nervenarzt 2004; 75 (10) 991-999.
    CrossrefPubMedSearch in Google Scholar
  • 19 Epifanov Y, Dodel R, Haacke C, Schaeg M, Schoffski O, Hennerici M. et al. Costs of acute stroke care on regular neurological wards: A comparison with stroke unit setting. Health Policy. 2007 im Druck.
    PubMedSearch in Google Scholar
  • 20 Kolominsky-Rabas PL, Heuschmann PU, Marschall D, Emmert M, Baltzer N, Neundorfer B. et al. Lifetime cost of ischemic stroke in Germany: results and national projections from a population-based stroke registry: the Erlangen Stroke Project. Stroke 2006; 37 (05) 1179-1183.
    CrossrefPubMedSearch in Google Scholar
  • 21 Neubauer G, Ujlaky R. Migraine -a disease and its costs. Pharm unserer Zeit 2002; 31 (05) 494-497.
    CrossrefPubMedSearch in Google Scholar
  • 22 Larbig W, Bruggenjurgen B. Work productivity and resource consumption among migraineurs under current treatment and during treatment with sumatriptan – An economic evaluation of acute treatment in moderate to severe migraineurs. Headache Quarterly 1997; 08 (03) 237-246.
    Search in Google Scholar
  • 23 Brüggenjürgen B. Lebensqualität und volkswirtschaftliche Kosten der Migräne in Deutschland. Sankt Augustin: Asgard Verlag Hippe 1994
    PubMedSearch in Google Scholar
  • 24 Göbel H, Buschmann P, Heinze A, Heinze-Kuhn K. Epidemiology and socioeconomic consequences of migraine and headache diseases. Versicherungsmedizin 2000; 52 (01) 19-23.
    PubMedSearch in Google Scholar
  • 25 Pfäfflin MM, Hermann S, Adelmeier U. Prävalenz, Behandlung und soziale Aspekte von Epilepsien in Deutschland: Erste Ergebnisse einer epidemiologischen Querschnittsstudie (EPIDEGStudie). Epilepsie-Blätter 1997; (10) 15-20.
    Search in Google Scholar
  • 26 Hamer H, Spottke A, Aletsee C, Knake S, Reis J, Oertel WH. et al. Direct and indirect costs of epilepsy in a tertiary epilepsy center in Germany. Epilepsia 2006; 47: 2165-2172.
    CrossrefPubMedSearch in Google Scholar
  • 27 Dodel RC, Pepperl S, Kohne-Volland R, Szucs T, Werhahn KJ, Noachtar S. et al. Costs of drug treatment of neurologic diseases: Parkinson disease, dystonia, epilepsy. Med Klinik 1996; 91 (07) 479-485.
    Search in Google Scholar
  • 28 Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol 2005; 12 (Suppl. 01) 1-27.
    Search in Google Scholar
  • 29 van Hout B, Gagnon D, Souetre E, Ried S, Remy C, Baker G. et al. Relationship between seizure frequency and costs and quality of life of outpatients with partial epilepsy in France, Germany, and the United Kingdom. Epilepsia 1997; 38 (11) 1221-1226.
    CrossrefPubMedSearch in Google Scholar
  • 30 Elwood W. Forgotten economic implications of Alzheimer disease. PharmacoEconomics & Outcomes News 1998; 167: 3-4.
    CrossrefSearch in Google Scholar
  • 31 Bickel H. Dementia in advanced age: estimating incidence and health care costs. Zeitschrift fur Gerontologie und Geriatrie 2001; 34 (02) 108-115.
    CrossrefPubMedSearch in Google Scholar
  • 32 Schulenburg JH, Grobe-Einsler R, Bernhardt T, Möller H, Schulenburg I. Kostenanalyse der Behandlung hirnleistungsgestörter Patienten. Geriatrie Forschung 1995; 05: 31-40.
    Search in Google Scholar
  • 33 Schulenburg I, Horn R, Möller H, Bernhardt T, Mast O. Cost of Treatment and Care of Alzheimer’s Disease in Germany. In: Wimo AJ, Karlsson G, Winblad B. (ed). Health economics of dementia. Chichester, England: John Wiley& Sons Ltd; 1998: 217-230.
    Search in Google Scholar
  • 34 Hallauer JFS, Smala A, Berger K. Untersuchung von Krankheitskosten bei Patienten mit Alzheimer-Erkrankung in Deutschland. Gesundheitsökon Qualitätsmanag 2001; 05: 73-79.
    Search in Google Scholar
  • 35 Kulp W, vd JMSchulenburg. Demographic challenges and medical research. Pharmacoeconomic aspects of treatment of dementia patients. Pharm Zeit 2002; 31 (04) 410-416.
    Search in Google Scholar
  • 36 Kleinhenz J, Vieregge P, Fassl H, Jörg J. Prävalenz des Morbus Parkinson in der Bundesrepublik Deutschland. Öff Gesundheitswes 1990; 52 (04) 181-190.
    Search in Google Scholar
  • 37 Dodel RC, Berger K, Oertel WH. Health-related quality of life and healthcare utilisation in patients with Parkinson’s disease: impact of motor fluctuations and dyskinesias. Pharmacoeconomics 2001; 19 (10) 1013-1038.
    CrossrefPubMedSearch in Google Scholar
  • 38 Jost WH. Costs in the treatment of parkinsonism. J Neurol 2000; 247 (Suppl. 04) IV31-IV34.
    Search in Google Scholar
  • 39 Meissner W, Trottenberg T, Klaffke S, Paul G, Kuhn AA, Arnold G. et al. Apomorphine therapy versus deep rain stimulation. Clinical and economic aspects in patients with advanced Parkinson disease. Nervenarzt 2001; 72 (12) 924-927.
    CrossrefPubMedSearch in Google Scholar
  • 40 Muller T, Voss B, Hellwig K, Josef FStein, Schulte T, Przuntek H. Treatment benefit and daily drug costs associated with treating Parkinson’s disease in a Parkinson’s disease clinic. CNS Drugs 2004; 18 (02) 105-111.
    CrossrefPubMedSearch in Google Scholar
  • 41 Spottke AE, Reuter M, Machat O, Bornschein B, von Campenhausen S, Berger K. et al. Cost of illness and its predictors for Parkinson’s disease in Germany. Pharmacoeconomics 2005; 23 (08) 817-836.
    CrossrefPubMedSearch in Google Scholar
  • 42 Stamm TS, Engfer A, Fahrenkrug K. Krankheitskosten des Morbus Parkinson in Deutschland. Psycho 1996; 22: 216-228.
    Search in Google Scholar
  • 43 Dengler I, Leukel N, Meuser T, Jost WH. Prospective study of the direct and indirect costs of idiopathic Parkinson’s disease. Nervenarzt 2006; 77: 1204-1209.
    CrossrefPubMedSearch in Google Scholar
  • 44 Keller S, Kessler T, Meuser T, Fogel W, Bremen D, Jost WH. Analysis of direct costs in therapy of Parkinson disease. Nervenarzt 2003; 74 (12) 1105-1109.
    CrossrefPubMedSearch in Google Scholar
  • 45 Barth F, Baum B, Bremen D, Meuser T, Jost WH. Die indirekten Kosten des idiopathischen Parkinsin-Syndroms. Fortschr Neurol Psychiatr 2005; 73 (04) 187-191.
    Thieme ConnectPubMedSearch in Google Scholar
  • 46 Keller S, Kessler T, Meuser T, Fogel W, Bremen D, Jost WH. et al. Inpatient costs, length of stay, and mortality for cerebrovascular events in community hospitals. A comparison of the costs and survival of hospital-admitted stroke patients across Europe. Nervenarzt 2003; 74 (12) 1105-1109.
    CrossrefPubMedSearch in Google Scholar
  • 47 Pollak P, Benabid AL, Limousin P, Benazzouz A, Hoffmann D, Le Bas JF. et al. Subthalamic nucleus stimulation alleviates akinesia and rigidity in parkinsonian patients. Adv Neurol 1996; 69: 591-594.
    Search in Google Scholar
  • 48 Moro E, Scerrati M, Romito LM, Roselli R, Tonali P, Albanese A. Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson’s disease. Neurology 1999; 53 (01) 85-90.
    CrossrefPubMedSearch in Google Scholar
  • 49 Spottke EA, Volkmann J, Lorenz D, Krack P, Smala AM, Sturm V. et al. Evaluation of healthcare utilization and health status of patients with Parkinson’s disease treated with deep brain stimulation of the subthalamic nucleus. Journal of Neurology 2002; 249 (06) 759-766.
    CrossrefPubMedSearch in Google Scholar
  • 50 Auger RG, Whisnant JP. Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984. Arch Neurol 1990; 47 (11) 1233-1234.
    CrossrefPubMedSearch in Google Scholar
  • 51 The Epidemiological Study of Dystonia in Europe Collaborative Group – ESDE. A prevalence study of primary dystonia in eight European countries. J Neurol 2000; 247 (10) 787-792.
    CrossrefPubMedSearch in Google Scholar
  • 52 Castelon EKonkiewitz, Trender-Gerhard I, Kamm C, Warner T, Ben-Shlomo Y, Gasser T. et al. Service-based survey of dystonia in Munich. Neuroepidemiology 2002; 21 (04) 202-206.
    CrossrefPubMedSearch in Google Scholar
  • 53 Dodel RC, Kirchner A, Koehne-Volland R, Kunig G, Ceballos-Baumann A, Naumann M. et al. Costs of treating dystonias and hemifacial spasm with botulinum toxin A. Pharmacoeconomics 1997; 12 (06) 695-706.
    CrossrefPubMedSearch in Google Scholar
  • 54 Drummond MF, O’Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 2nd ed.. New York: Oxford University Press; 1997
    Search in Google Scholar
  • 55 Hannoveraner Konsensusgruppe. Deutsche Empfehlungen zur gesundheitsökonomischen Evaluation – Revidierte Fassung des Hannoveraner Konsens. Gesundheitsökonomie und Qualitätsmanagement 1999; (04) A62-A65.
    Search in Google Scholar