Abstract
Background
The aims of our study were to describe the costs associated with diabetic retinopathy (DR), and to evaluate its economic impact in Germany.
Methods
Forty-one German ophthalmologists, randomly selected from a physicians’ database in Germany, provided information on adult Type 1 and Type 2 diabetic patients with DR (n = 207). This information included socio-demographics, clinical characteristics and resource use during the year 2002. National-level cost estimates were calculated, based on these results and the prevalence data on DR in Germany.
Results
This study found that costs associated with DR tend to increase as DR progresses, being highest in patients with proliferative DR and lowest in patients with mild, non-proliferative DR. The German statutory health insurance (Gesetzliche Krankenversicherung, GKV) covered two-thirds of the total costs paid by all the payers. The total cost of DR from a societal perspective was calculated at €3.51 bn for the year 2002, and from the GKV perspective amounted to €2.23 bn.
Conclusions
This study is the first comprehensive study to provide estimates of costs associated with DR in Germany. These costs were estimated to account for approximately 1.5% of the total health-care expenditure in 2002.
Similar content being viewed by others
Abbreviations
- DM:
-
diabetes mellitus
- NPDR:
-
non-proliferative diabetic retinopathy
- SNPDR:
-
severe non-proliferative diabetic retinopathy
- PDR:
-
proliferative diabetic retinopathy
- ME:
-
macular edema
- GKV:
-
Gesetzliche Krankenversicherung (statutory health insurance)
References
Horle S, Gruner F, Kroll P (2002) Epidemiology of diabetes-induced blindness—a review. Klin Monatsbl Augenheilkd 219:777–784 (in German)
World Health Organisation (2002) Diabetes mellitus. Fact sheet N° 138. Available from http://www.who.int/mediacentre/factsheets/fs138/en/print.html (accessed 2006)
Coyne KS, Margolis MK, Kennedy-Martin T, Baker TM, Klein R, Paul MD et al (2004) The impact of diabetic retinopathy: perspectives from patient focus groups. Fam Pract 21:447–453
Rein DB, Zhang P, Wirth KE, Lee PP, Hoerger TJ, McCall N et al (2006) The economic burden of major adult visual disorders in the United States. Arch Ophthalmol 124(12):1754–1760
Center for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada (2002) Diabetes in Canada. Available from http://www.phac-aspc.gc.ca/publicat/dic-dac2/pdf/dic-dac2_en.pdf (accessed 2006)
O’Brien JA, Patrick AR, Caro JJ (2003) Cost of managing complications resulting from type 2 diabetes mellitus in Canada. BMC Health Serv Res 21;3(1):7
Stock SA, Redaelli M, Wendland G, Civello D, Lauterbach KW (2006) Diabetes—prevalence and cost of illness in Germany: a study evaluating data from the statutory health insurance in Germany. Diabet Med 23:299–305
Jönsson B (2002) Revealing the cost of Type II diabetes in Europe. Diabetologia 45:5–12
Koster I, von Ferber L, Ihle P, Schubert I, Hauner H (2006) The cost burden of diabetes mellitus: the evidence from Germany-the CoDiM Study. Diabetologia 49:1498–1504
Hörle S, Kroll P (2005) Evidence based medicine using the example of diabetic retinopathy treatment. Dtsch Arztebl 102(38):2570–2577 (in German)
Schwarzeck-Verlag GmbH. The reference medical professional database. Available from http://www.d-medico.de (accessed 2002)
Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M et al (2006) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682
AMGEN GmbH. Einheitlicher Bewertungsmaßstab (EBM) (2002) Available from http://www.gesundheitspolitik.net/02_ambulante_versorgung/abrechnung/ebm/ebm2002-010101.pdf (accessed 2002)
Kassenärztliche Bundesvereinigung. Politisches Aktionsprogramm der Kassenärzte. 2002. Available from http://www.kbv.de/gesundheitspolitik/1365.html (accessed 2002)
Rote Liste Service GmbH (2002) Rote Liste 2002. Editio Cantor, Aulendorf
Schwabe U, Paffrath D (2003) Arzneimittelverordnungsreport 2002. Springer-Verlag Berlin, Heidelberg
http://www.sozialpolitik-aktuell.de. Neuregelungen im Bereich Krankenversicherung. 2003. Available from http://www.sozialpolitik-aktuell.de/docs/neuregelungen-krankenversicherung.pdf (accessed 2003)
Tumorzentrum Heidelberg, Mannheim. Das Sozialrecht in der medizinischen und sozialen Rehabilitation von Krebskranken. 6.überarbeitete Auflage. 2001. Available from http://www.dkfz-heidelberg.de/tzhdma/texte/tr13.pdf (accessed 2002)
Statistisches Bundesamt (Federal Statistical Office of Germany) (2003) Statistical yearbook 2003. Statistisches Bundesamt, Wiesbaden
Scherbaum W. German Diabetes Center. Diabetes mellitus. Available from http://www.diabetes.uni-duesseldorf.de/wasistdiabetes/grundlagen/index.html?TextID=1996 (accessed 2005)
World Health Organisation. Prevalence of diabetes in the WHO European Region. Available from http://www.who.int/diabetes/facts/world_figures/en/print.html (accessed 2005)
Lehnert H, Wittchen HU, Pittrow D, Bramlage P, Kirch W, Bohler S et al (2005) Prevalence and pharmacotherapy of diabetes mellitus in primary care. Dtsch Med Wochenschr 130:323–328 (in German)
Bertram B (1997) Prevalence of patients with diabetes mellitus without and with retinopathy in an ophthalmology practice. Ophthalmologe 94:401–404 (in German)
Hesse L, Grusser M, Hoffstadt K, Jorgens V, Hartmann P, Kroll P (2001) Population-based study of diabetic retinopathy in Wolfsburg. Ophthalmologe 98:1065–1068 (in German)
Scherbaum W. German Diabetes Center. Diabetes mellitus. Available from http://www.diabetes.uni-duesseldorf.de/index.html?TextID=1918 (accessed 2005)
MediTech Media Ltd. Science blog. Reducing the costs of diabetes in Europe: preventing complications is the key. Available from http://www.scienceblog.com/community/older/1999/B/199901871.html (accessed 2006)
Koster I, Hauner H, von Ferber L (2006) Heterogeneity of costs of diabetic patients: the cost of diabetes mellitus study. Dtsch Med Wochenschr 131:804–810 (in German)
Federal Statistical Office of Germany. Health expenditure has further increased. Available from http://www.destatis.de/presse/englisch/pm2004/p0660095.htm (accessed 2006)
Acknowledgements
We thank two anonymous reviewers for their valuable comments on the paper.
This research was supported by Lilly Germany GmbH, Bad Homburg.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Happich, M., Reitberger, U., Breitscheidel, L. et al. The economic burden of diabetic retinopathy in Germany in 2002. Graefes Arch Clin Exp Ophthalmol 246, 151–159 (2008). https://doi.org/10.1007/s00417-007-0573-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-007-0573-x