Brüggenjürgen B , Andersohn F , Ezzat N , Lacey L , Willich S
J Med Econ.2015 Feb 18 ; ():1-24.
PMID: 25692902[PubMed - as supplied by publisher]
Abstract Objective The main objective of this analysis was to assess the medical and economic differences between patients with and without diagnosed Alzheimer Disease (AD). Analysis included co-morbidities, patterns of drug use, and clinical course, as well as the magnitude of these differences attributable to AD. Methods This evaluation is based on retrospective analyses of anonymized claims data from 2005 to 2008 provided by a large German Statutory Health Insurance (SHI). Cross sectional analyses were performed with the following data: demographics, number of hospitalizations, number of in-patient days, number of ambulatory physician visits, number of drugs used, total number of defined daily doses (DDD) of prescribed drugs, and costs. A propensity score model was used to assess costs attributable to AD. Results Patients with AD caused substantially higher costs from the perspective of a SHI. The differences in long-term care costs explained 70-75% of the total cost difference, with being responsible for about half of the total costs in AD patients. Comparing matched AD patients with controls resulted in 2.2 to 2.4 fold higher costs in the cross-sectional analysis, 7,413-9,207 Euros for AD patients vs. 3,378-3,850 Euros for controls. The propensity score model resulted in a difference of 3,771 Euros attributable to AD. These costs are mainly caused by differences in hospitalization and long-term care costs. Conclusion This analysis is one of the largest health economic studies of AD in Germany. The limitations of this study include the fact that reported diagnosis couldn't be validated and disease severity was not taken into account. Despite these methodological constraints, it can be concluded, that AD is a substantial cost driver from the SHI payer perspective in Germany.