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"Cost of Illness"
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Cost-of-Illness Studies
Cost-of-illness (COI) studies aim to assess the economic burden of health problems on the population overall, and they are conducted for an ever widening range of health conditions and geographical settings. While they attract much interest from public health advocates and healthcare policy makers, inconsistencies in the way in which they are conducted and a lack of transparency in reporting have made interpretation difficult, and have ostensibly limited their usefulness. Yet there is surprisingly little in the literature to assist the non-expert in critically evaluating these studies. This article aims to provide non-expert readers with a straightforward guide to understanding and evaluating traditional COI studies. The intention is to equip a general audience with an understanding of the most important issues that influence the validity of a COI study, and the ability to recognize the most common limitations in such work.
Journal Article
Economic evaluation of Motor Neuron Diseases: a nationwide cross-sectional analysis in Germany
Background and objectives
Motor Neuron Diseases (MND) are rare diseases but have a high impact on affected individuals and society. This study aims to perform an economic evaluation of MND in Germany.
Methods
Primary patient-reported data were collected including individual impairment, the use of medical and non-medical resources, and self-rated Health-Related Quality of Life (HRQoL). Annual socio-economic costs per year as well as Quality-Adjusted Life Years (QALYs) were calculated.
Results
404 patients with a diagnosis of Amyotrophic Lateral Sclerosis (ALS), Spinal Muscular Atrophy (SMA) or Hereditary Spastic Paraplegia (HSP) were enrolled. Total annual costs per patient were estimated at 83,060€ in ALS, 206,856€ in SMA and 27,074€ in HSP. The main cost drivers were informal care (all MND) and disease-modifying treatments (SMA). Self-reported HRQoL was best in patients with HSP (mean EuroQoL Five Dimension Five Level (EQ-5D-5L) index value 0.67) and lowest in SMA patients (mean EQ-5D-5L index value 0.39). QALYs for patients with ALS were estimated to be 1.89 QALYs, 23.08 for patients with HSP and 14.97 for patients with SMA, respectively. Cost-utilities were estimated as follows: 138,960€/QALY for ALS, 525,033€/QALY for SMA, and 49,573€/QALY for HSP. The main predictors of the high cost of illness and low HRQoL were disease progression and loss of individual autonomy.
Conclusion
As loss of individual autonomy was the main cost predictor, therapeutic and supportive measures to maintain this autonomy may contribute to reducing high personal burden and also long-term costs, e.g., care dependency and absenteeism from work.
Journal Article
The costs of bipolar disorder in the United Kingdom
Objectives To estimate the individual cost and population‐level economic burden of Bipolar Disorder (BD), and explore the impact of clinical and sociodemographic factors on costs in the United Kingdom. Methods Annual UK health care, social care and societal cost data were collected from a prospective cohort of 91 BD patients using digital monitoring of symptoms. Costs (in £) were calculated for the year of resource use collection (2010–2011) and main results inflated to year 2018–2019. A Generalized Estimating Equation framework was used to investigate individual factors influencing costs. An economic burden estimate was derived by multiplying the mean annual cost per patient with literature‐based population prevalence. Results The average annual cost of BD per patient was £12,617 (SE = ±£1085) or £14,938 (SE = ±£1281) at 2018–2019 prices with 68% of the total costs attributed to lost productivity and informal care, 31% to health care costs, 1% to private out‐of‐pocket expenses, and 0.5% to social care costs. A unit increase in average levels of depressive or manic symptoms were associated with 7% and 11% higher societal costs, respectively. The estimated annual prevalence of BD in the United Kingdom was 0.8% resulting in a population‐level economic burden estimate of £5.1 billion for 2010–2011 or £6.43 billion for 2018–2019. Conclusions BD is a disease of substantial costs in the United Kingdom with the majority of the economic burden falling outside the health care system in the form of productivity losses and informal care. These costs highly correlate with patient outcomes highlighting further needs for improved treatment efforts into functionality. We assess the individual cost and population‐level economic burden of Bipolar Disorder (BD), and explore the impact of clinical and sociodemographic factors on costs in the United Kingdom. Based on a prospective cohort of 91 BD patients, we estimate an annual prevalence of BD in the United Kingdom of 0.8% and average annual costs of BD £12,617 per patient in 2010–2011, resulting in a population‐level economic burden estimate of £5.1 billion for 2010–2011 or £6.43 billion adjusted to 2018–2019 prices. We further provide a breakdown of the annual costs per major cost categories.
Journal Article
Approaching Global Oncology
The gap between the required and available cancer care in the world widened in the last decade for the majority of cancer patients. This book presents the need for global approaches and campaign for the scientific exploration of avenues to increase affordability of better value cancer treatment for millions of cancer patients in the world.
eBook
Food Attribution and Economic Cost Estimates for Meat- and Poultry-Related Illnesses
The economic burden of foodborne illness has been estimated to be as high as US$90 billion annually. For policy purposes, it is often important to understand not only the overall cost of illness but also the costs associated with individual products or groups of products. In this study, I estimate the cost of foodborne illnesses from 29 pathogens associated with nongame meat and poultry products that are regulated by the U.S. Department of Agriculture. To complete this, I merge results from a food attribution model with results from an illness model and an economic burden of illness model. The food attribution model uses outbreak and expert elicitation data to attribute foods to pathogens. The illness model is a replication of the 2011 study published by the Centers for Disease Control and Prevention. The economic cost model is an updated version of previously published studies that include costs for medical care, lost productivity, loss of life, and pain and suffering. The primary attribution model, based largely on Interagency Food Safety Analytics Collaboration assumptions, estimates that meat and poultry products are vectors for 30.9% of all foodborne illnesses. This translates into 2.9 million annual illnesses, yielding economic costs of up to $20.3 billion. The costliest food-pathogen pairs include Campylobacter spp. in poultry ($6.9 billion), Salmonella spp. in chicken and pork ($2.8 and $1.9 billion, respectively), and Toxoplasma gondii in pork ($1.9 billion). Results based on alternative attribution and economic model assumptions are also presented, generating meat and poultry attribution estimates ranging from 27.1 to 36.7% and economic costs of $8.1 to $22.5 billion.
Journal Article
The incremental healthcare cost associated with cancer in Belgium: A registry‐based data analysis
Background Similar to many countries, Belgium experienced a rapid increase in cancer diagnoses in the last years. Considering that a large part of cancer types could be prevented, our study aimed to estimate the annual healthcare burden of cancer per site, and to compare cost with burden of disease estimates to have a better understanding of the impact of different cancer sites in Belgium. Methods We used nationally available data sources to estimate the healthcare expenditure. We opted for a prevalence‐based approach which measures the disease attributable costs that occur concurrently for 10‐year prevalent cancer cases in 2018. Average attributable costs of cancer were computed via matching of cases (patients with cancer by site) and controls (patients without cancer). Years of life lost due to disability (YLD) were used to summarize the health impact of the selected cancers. Results The highest attributable cost in 2018 among the selected cancers was on average €15,867 per patient for bronchus and lung cancer, followed by liver cancer, pancreatic cancer, and mesothelioma. For the total cost, lung cancer was the most costly cancer site with almost €700 million spent in 2018. Lung cancer was followed by breast and colorectal cancer that costed more than €300 million each in 2018. Conclusions In our study, the direct attributable cost of the most prevalent cancer sites in Belgium was estimated to provide useful guidance for cost containment policies. Many of these cancers could be prevented by tackling risk factors such as smoking, obesity, and environmental stressors.
Journal Article
The cost of mental disorders: a systematic review
To identify and synthesise the literature on the cost of mental disorders.
Systematic literature searches were conducted in the databases PubMed, EMBASE, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to January 1980-May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses; (2) diagnosis of at least one mental disorder; (3) study population based on the general population; (4) outcome in monetary units. The systematic review was preregistered on PROSPERO (ID: CRD42019127783).
In total, 13 579 potential titles and abstracts were screened and 439 full-text articles were evaluated by two independent reviewers. Of these, 112 articles were included from the systematic searches and 31 additional articles from snowball searching, resulting in 143 included articles. Data were available from 48 countries and categorised according to nine mental disorder groups. The quality of the studies varied widely and there was a lack of studies from low- and middle-income countries and for certain types of mental disorders (e.g. intellectual disabilities and eating disorders). Our study showed that certain groups of mental disorders are more costly than others and that these rankings are relatively stable between countries. An interactive data visualisation site can be found here: https://nbepi.com/econ.
This is the first study to provide a comprehensive overview of the cost of mental disorders worldwide.
Journal Article
Cost-of-illness studies: concepts, scopes, and methods
Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis.
Journal Article