title: Healthcare costs and resource utilization of asthma in Germany: a claims data analysis.
abstract: BACKGROUND
  Asthma is associated with a substantial economic burden on the German Statutory Health Insurance.
  
  
  OBJECTIVE
  To determine costs and resource utilization associated with asthma and to analyze the impact of disease severity on subgroups based on age and gender.
  
  
  METHODS
  A claims database analysis from the statutory health insurance perspective was conducted. Patients with an ICD-10-GM code of asthma were extracted from a 10% sample of a large German sickness fund. Five controls for each asthma patient matched by age and gender were randomly selected from the same database. Costs and resource utilization were calculated for each individual in the asthma and control group. Incremental asthma-related costs were calculated as the mean cost difference. Based on prescribed asthma medication, patients were classified as intermittent or persistent. In addition, age groups of ≤ 5, 6-18, and >18 years were analyzed separately and gender differences were investigated.
  
  
  RESULTS
  Overall, 49,668 individuals were included in the asthma group. On average, total annual costs per patient were €753 higher (p = 0.000) compared to the control group (€2,168 vs. €1,415). Asthma patients had significantly higher (p = 0.000) outpatient (€217), inpatient (€176), and pharmacy costs (€259). Incremental asthma-related total costs were higher for patients with persistent asthma compared to patients with intermittent asthma (€1,091 vs. €408). Women aged >18 years with persistent asthma had the highest difference in costs compared to their controls (€1,207; p < 0.0001). Corresponding healthcare resource utilization was significantly higher in the asthma group (p = 0.000).
  
  
  CONCLUSIONS
  The treatment of asthma is associated with an increased level of healthcare resource utilization and significantly higher healthcare costs. Asthma imposes a substantial economic burden on sickness funds.
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany. christian.jacob@xcenda.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Jacob
authors.affiliation: GlaxoSmithKline, Uxbridge, Greater London, UK.
authors.forename: Benno
authors.initials: B
authors.lastname: Bechtel
authors.affiliation: Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Engel
authors.affiliation: Group Practice and Centre for Pneumology Allergy and Sleep Medicine at Red Cross Maingau Hospital, Frankfurt Am Main, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kardos
authors.affiliation: Scientific Institute of TK for Benefit and Efficiency in Health Care, Hamburg, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Linder
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Braun
authors.affiliation: Faculty of Health Sciences, University of Bielefeld, Bielefeld, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Greiner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000191:economics / Q000627:therapeutic use; D001249:Asthma / Q000191:economics* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007345:Insurance Claim Review; D008297:Male; D012737:Sex Factors; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Asthma; Claims data; Cost of illness; Disease severity; Intermittent; Persistent