Hepatocellular carcinoma after prior sorafenib treatment: incidence, healthcare utilisation and costs from German statutory health insurance claims data.

Objective: To estimate both the number of patients with hepatocellular carcinoma (HCC) eligible annually for second-line therapy following sorafenib in Germany and the healthcare costs accrued by patients meeting eligibility criteria.

Methods: Patients with an HCC diagnosis and one or more sorafenib prescription were identified from samples of > 3 million insured persons in each of 2012, 2013 and 2014 using the anonymised Betriebskrankenkasse health insurance scheme database. Incidence rates from 2013 were extrapolated to the German population using data from the statutory health insurance system database and Robert Koch Institute.

Patient preferences for palliative treatment of locally advanced or metastatic gastric cancer and adenocarcinoma of the gastroesophageal junction: a choice-based conjoint analysis study from Germany.

Background: Decisions on palliative chemotherapy (CT) for locally advanced or metastatic gastric cancer (mGC) require trade-offs between potential benefits and risks for patients. Healthcare providers and payers agree that patient-preferences should be considered. We conducted a choice-based conjoint (CBC) analysis study in pre-treated patients from Germany with mGC or locally advanced or metastatic adenocarcinoma of the gastroesophageal junction (mGEJ-Ca), to evaluate their preferences when hypothetically selecting a CT regimen.

Use of Structural Equation Modeling to Demonstrate the Differential Impact of Storage and Voiding Lower Urinary Tract Symptoms on Symptom Bother and Quality of Life during Treatment for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia.

Purpose: Lower urinary tract symptoms associated with benign prostatic hyperplasia typically respond well to medical therapy. While changes in total I-PSS (International Prostate Symptom Score) are generally accepted as measurement for treatment response, I-PSS storage and voiding subscores may not accurately reflect the influence of symptom improvement on patient bother and quality of life.

Materials And Methods: Structural equation modeling was done to evaluate physiological interrelationships measured by I-PSS storage vs voiding subscore questions and measure the magnitude of effects on bother using BII (Benign Prostatic Hyperplasia Impact Index) and quality of life on I-PSS quality of life questions.

Patient preferences for outcomes of depression treatment in Germany: a choice-based conjoint analysis study.

Background: In general, treatment efficacy in depressed patients is evaluated mainly based on the core symptoms of depression. However, patients might consider different outcomes. This study used choice-based conjoint analysis (CBC) to evaluate patient preferences for depression treatment outcomes.

Preferences of diabetes patients and physicians: a feasibility study to identify the key indicators for appraisal of health care values.

Background: Evidence-based medicine, the Institute of Medicine (IOM) and the German Institute for Quality and Efficiency in Health Care (IQWiG), support the inclusion of patients' preferences in health care decisions. In fact there are not many trials which include an assessment of patient's preferences. The aim of this study is to demonstrate that preferences of physicians and of patients can be assessed and that this information may be helpful for medical decision making.

Expenditures of the German statutory health insurance system for patients suffering from acute coronary syndrome and treated with percutaneous coronary intervention.

Patients with acute coronary syndrome (ACS) are in need of cost-intensive treatment involving different aspects of the German Health System. Percutaneous coronary intervention (PCI) is the treatment of choice for a large proportion of cases. In the present study, an analysis of the cost impact of ACS with focus on PCI therapy was conducted across-the-board for the German Health System.

Diabetic retinopathy and health-related quality of life.

Objective: To describe the impact of co-morbidities, visual acuity, diabetic retinopathy (DR) grade, and macular edema (ME) on the health-related quality of life (HRQOL) among patients with diabetic retinopathy.

Methods: Analysis of data of 207 patients with diabetic retinopathy from Germany in 2003. HRQOL assessment was done using the generic (SF-12) questionnaire.

The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002--results from the Diabetic Microvascular Complications (DIMICO) study.

Objective: To describe the health-related quality of life (HRQOL), the resource utilization and annual costs associated with diabetic neuropathy (DN) in Germany.

Methods: In this retrospective, observational study German internists, diabetologists and general practitioners provided information on 185 adult type 1 and type 2 diabetic patients with DN. Health-related quality of life (HRQOL) was assessed using generic and disease specific questionnaires.

Predisposing factors for early retirement in patients with schizophrenia in Germany.

Although early retirement causes major changes in the life of schizophrenic patients and is among the major cost factors to be covered by payers, the causes leading to early retirement of schizophrenic patients have not been investigated in detail. Therefore, the objective of this retrospective non-interventional case-control study was to generate hypotheses on predisposing factors for early retirement in schizophrenia. Logistic regression was used to explore potential predisposing parameters with regard to their effect on the outcome early retirement.

Constructing an Index for the Subjective Well-being Under Neuroleptics scale (SWN), short form: applying structural equation modeling for testing reliability and validity of the index.

Structural equation modeling (SEM) has been widely used in psychology and sociology for testing validity of measurement instruments. However, this statistical technique has so far played minor role in quality-of-life research. The main objective of this paper is to demonstrate the potential of SEM for constructing and testing the validity of a Subjective Well-being under Neuroleptics (SWN) index for patients with schizophrenia.

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany.

Second-generation atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, ziprasidone, amisulpride and ariprazole offer the potential to reduce the significant health care resource demands in the treatment of schizophrenia through improved levels of initial clinical response and reduced levels of long-term acute relapse. However, the optimal sequencing of these drugs remains unclear. To consider this issue from a health economic viewpoint a decision model approach was used comparing healthcare costs and clinical outcomes when treating patients with alternative sequences of atypical antipsychotic treatment.

Length of hospital stay and associated costs for olanzapine vs. haloperidol in the treatment of schizophrenia relapse in Germany.

We examined the number of days spent in hospital due to a relapse of schizophrenia and the associated costs for patients treated with olanzapine or haloperidol. Twenty-one German psychiatric hospitals participated in this retrospective study. Data on the last hospitalisation following a relapse of schizophrenia were documented for equal numbers of patients on olanzapine and haloperidol.

Burden of illness imposed by severe sepsis in Germany.

Sepsis is a systemic response to severe infection in critically ill patients and is among the most frequent causes of death in intensive care medicine. Every year between 44,000 and 95,000 persons suffer from this illness in Germany. With the help of a retrospective electronic chart analysis in three adult ICUs of three university hospitals we calculated by a bottom-up approach the direct costs of these patients yielding per patient costs of 23,297 euros on average.

[Costs of early retirement--the case of schizophrenia].

Schizophrenia is a severe psychic disorder that occurs at young age and often leads to a work disability. The disease not only induces direct costs in the health care system but also indirect costs that show up in the social security system. In this study, we apply statistics from the social security administration on early retirement due to disability.

Cost-effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in Germany.

Drotrecogin alfa (activated) (Xigris; Eli Lilly and Company, Indianapolis, IN) significantly reduced mortality in severe sepsis in the PROWESS trial. We evaluate the cost-effectiveness of drotrecogin alfa (activated) as an adjunct to standard therapy from the German healthcare payer's perspective with respect to patients with 1) severe sepsis and 2) severe sepsis and multiple organ failure the approved European indication. Hospital resource use based on PROWESS was valued using German unit costs.