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Table 2 Direct medical costs of several cardiovascular diseases in Germany (2003–2013) from a healthcare provider or SHI perspective

From: Costs of treating cardiovascular events in Germany: a systematic literature review

Study Disease Study design Sample size Gender (% male) Age (mean ± SD years) Unit of costs Costs in the acute phase (actual costs; % of costs in the 1st year) 2014 € Inflation adjusted costs in acute phasea Costs/patient in the first 6 months (actual costs; % of the costs in the 1st year)b 2014 € Inflation adjusted costs/patient in the first 6 monthsa Costs/patient in the 1st year after event 2014 € Inflation adjusted costs/patient in the 1st year after eventa Costs/patient in subsequent years 2014 € Inflation adjusted Costs/patient in subsequent yearsa Other costs 2014 € Inflation adjusted other costsa Note
Myocardial infarction and unstable angina
Stargardt 2013 [11] MI Retrospective claim database analysis 12,284 71.60 % 64.1 2004–2006 € n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. Hospitalization costs: 6936 Hospitalization costs: 7927 Used provider reimbursement for costs
Reinöhl 2012 [12] AMI Real-world scenario administrative routine data analysis (cross sectional study) 1409 n.a. n.a. Not stated in publication, assume year of publication 2012. n.a. n.a. n.a. n.a. 3461.82–4643.15 depending on different anticoagulant strategy used for PCI treatment 3545–4755 depending on different anticoagulant strategy used for PCI treatment n.a. n.a. In-hospital costs: In-hospital costs: Only patients underwent PCI at high volume centers
aUsing UFH monotherapy: 3807.2 ± 2235.98; aUsing UFH monotherapy: 3899 ± 2290;
aUFH + glycoprotein IIb/IIIa receptor inhibitor: 4643.15 ± 4662.48; aUFH + glycoprotein IIb/IIIa receptor inhibitor: 4755 ± 4775;
aBivalirudin: 3461.82 ± 1301.96 aBivalirudin: 3545 ± 1333
Bäumler 2012 [10] MI Retrospective claims data analysis DES: 719; BMS: 719 DES: 86.20 %; BMS: 86.07 % DES: 60.7 (11.2); BMS: 62.2 (11.0) 2005 30 day (acute) costs were 7761 for DES group and 6704 for BMS group 30 day (acute) costs were 9030 for DES group and 7800 for BMS group n.a. n.a. DES: 12,713 (SD 10,753); BMS: 11,714 (SD 9967) DES: 14,792 (SD 12,511); BMS: 13,629 (SD 11,597) n.a. n.a. n.a. n.a. Only patients with PCI; First MI only, excluded re-infarct
Reinhold 2011 [13] MI Retrospective claim data analysis 15,185 57.43 % 71.1 ± 12.6 2004/2005 € 5836; 50 % 6790 9897; 80 % 11,515 12,372 14,395 n.a. n.a. n.a. n.a. Largest SHI with representative sample; excluded recurrent events
Tiemann 2008 [15] AMI Retrospective study using hospital administration data n.a. 100 % 50–60 2005 3113 from SHI perspective; 2866 from hospital perspective 3622 from SHI persp.; 3335 from hospital persp. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. Selective patient group (i.e. no revascularization, no teaching hospitals)
Fuchs 2008 [16] MI Calculate costs based on expert interview resource utilization data/or published data and German SHI price n.a. n.a. Assume 70 % over 60 years old 2005 4560 5306 n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. No information on resource use estimates
Brüggenjürgen 2006 [18] Hospitalized UA Prospective cross-sectional study in 19 hospitals of different health care levels 407 67.1 % 65.9 (11.6) 2000–2002 € 3644 (SD 2195, 95 % CI: 3430–3858) 4442 (SD 2676, 95 % CI: 4181–4703) n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a.
Brüggenjürgen 2005 [17] MI Calculate costs based on expert panel resource utilization data and German SHI price n.a. n.a. n.a. 2004 7522; 64 % 8918 85 % n.a. 11,672 13,838 981 during month 13–18 after the event 1163 during month 13–18 after the event n.a. n.a. Expert panel stated 57 % PTCA, 7 % CABG, 7 % pacemaker, 69 % rehab
Chronic heart failure
Biermann 2012 [19] CHF Retrospective panel study using claims data 2,71 74.8 % 62.9 ± 13.6 2009 n.a. n.a. n.a. n.a. 3150 3417 n.a. n.a. Inpatient care: 74 % n.a. Included NYHA I-IV
Medication: 9 %;
Rehabilitation: 9 %
outpatient contact: 8 %
Peters-Klimm 2012 [20] CHF Retrospective medical chart analysis 159 73 % 68.5 ± 10.2 2004–2005 € n.a. n.a. n.a. n.a. 4792 ± 8249 5576 ± 9598 n.a. n.a. Total hospitalization: 3545 (8065), including HF 466 (1525), other CV-related hospitalization 2596 (7469), and other causes of hospitalization 483 (1894); Total hospitalization: 4125 (9384), including HF 542 (1774), other CV-related hospitalization 3020 (8690), and other causes of hospitalization 562 (562); 53 % NYHA II, 45 % NYHA III; Based on a RCT regarding an innovative medical education on primary care-based patients
Medication: 854 (835) Medication: 994 (972)
Peripheral artery disease
Brüggenjürgen 2005 [17] PAD Calculate costs based on expert panel resource utilization data and German SHI price n.a. n.a. n.a. 2004 4186; 55 % 4963 2138; 28 % 2535 7674 9098 1172 during month 13–18 after the event 1390 during month 13–18 after the event 2138 for month 1–6; 1350 for month 7-12 2535 for month 1–6; 1601 for month 7–12 Only hospitalized patients included
Stroke
Abbas 2013 [21] Ischemic Stroke Claims data analysis Hospital based: 1272; 28 % hospital-based, 33 % for facility 80–81 years 2007 n.a. n.a. n.a. n.a. Hospital based: 15,573; rehabilitation facility based: 15,726 Hospital based: 17,399 rehabilitation facility based: 17,570 n.a. n.a. n.a. n.a. Rehab patients only
Rehabilitation facility based: 2200
Lindig 2010 [22] Stroke Retrospective claim data analysis 18,106 43.6 % 73.7 ± 12.6 years 2004/2005 € Around 50 % n.a. Around 80 % n.a. 11,408 13,273 n.a. n.a. n.a. n.a. All hospitalized patients; includes hemorrhagic & ischemic strokes
Fuchs 2008 [16] Ischemic stroke Calculate costs based on expert interview resource utilization data/or published data and German SHI price n.a. n.a. Assume 70 % over 60 years old 2005 4780 5562 n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a.
Kolominsky-Rabas 2006 [23] Ischemic stroke Retrospective cost of illness study based on a population-based longitudinal registry database and German SHI prices. 821 45 % 52 % patients were in the age group >75 years, women (76.3), men (70.6) 2004 n.a. n.a. n.a. n.a. 18,517 21,954 Annual costs for subsequent 4 years were 5479/patient. Annual costs for subsequent 4 years were 6496/patient. n.a. n.a. First-year survivors after first-ever stroke
Brüggenjürgen 2005 [17] Ischemic stroke Calculate costs based on expert panel resource utilization data and German SHI price n.a. n.a. n.a. 2004 5134; 29 % 6087 6727; 66 % 7976 17,864 21,180 5280 during month 13–18 after the event 6260 during month 13–18 after the event 6003 for months 7–12 7117 for months 7–12 Experts estimated 53 % rehab facility, 45 % inpatient rehab
  1. Note: “Costs” in this table is limited to direct medical costs from a SHI perspective in Germany. n.a. means not available. n.r. means not relevant
  2. aInflation adjusted costs according to CPI: OECE statistics extracts, http://stats.oecd.org/Index.aspx?DataSetCode=MEI_CPI_WEIGHTS#, accessed on AUG 10 2015
  3. bThe costs incurred in the first 6 months include those incurred in the acute phase