Cost of clinical events in health economic evaluations in Germany: a systematic review

Cost Effectiveness and Resource Allocation

Review

Volker Ulrich¹  Narine Sahakyan²  Monika Scheuringer³  Karl J Krobot⁴ 

[1] Department of Law and Economics, Institute of Public Finance, University of Bayreuth, Bayreuth, Germany;Department of Medical Informatics, Biometry, and Epidemiology, Ludwig Maximilians University Munich, Munich, Germany;Division of Public Health Decision Modelling, Health Technology Assessment and Health Economics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria;Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT- University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria;Outcomes Research Department, MSD Sharp & Dohme GmbH, Haar, Germany;Outcomes Research Department, MSD Sharp & Dohme GmbH, Haar, Germany;Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT- University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria;

关键词: Costs;    Diabetes mellitus;    Germany;    Health economics;   

DOI  :  10.1186/1478-7547-10-7

 received in 2011-08-04, accepted in 2012-04-14,  发布年份 2012

来源: Springer

【 摘 要 】

Guidance from the Institute for Quality and Efficiency in Health Care (IQWiG) on cost estimation in cost–benefit assessments in Germany acknowledges the need for standardization of costing methodology. The objective of this review was to assess current methods for deriving clinical event costs in German economic evaluations. A systematic literature search of 24 databases (including MEDLINE, BIOSIS, the Cochrane Library and Embase) identified articles, published between January 2005 and October 2009, which reported cost-effectiveness or cost-utility analyses. Studies assessed German patients and evaluated at least one of 11 predefined clinical events relevant to patients with diabetes mellitus. A total of 21 articles, describing 199 clinical cost events, met the inclusion criteria. Year of costing and time horizon were available for 194 (97%) and 163 (82%) cost events, respectively. Cost components were rarely specified (32 [16%]). Costs were generally based on a single literature source (140 [70%]); where multiple sources were cited (32 [16%]), data synthesis methodology was not reported. Cost ranges for common events, assessed using a Markov model with a cycle length of 12 months, were: acute myocardial infarction (nine studies), first year, 4,618–17,556 €; follow-up years, 1,006–3,647 €; and stroke (10 studies), first year; 10,149–24,936 €; follow-up years, 676–7,337 €. These results demonstrate that costs for individual clinical events vary substantially in German health economic evaluations, and that there is a lack of transparency and consistency in the methods used to derive them. The validity and comparability of economic evaluations would be improved by guidance on standardizing costing methodology for individual clinical events.

【 授权许可】

CC BY   
© Scheuringer et al.; licensee BioMed Central Ltd. 2012