The economic burden of diabetic retinopathy in Germany in 2002



The aims of our study were to describe the costs associated with diabetic retinopathy (DR), and to evaluate its economic impact in Germany.


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.


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.


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.

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diabetes mellitus


non-proliferative diabetic retinopathy


severe non-proliferative diabetic retinopathy


proliferative diabetic retinopathy


macular edema


Gesetzliche Krankenversicherung (statutory health insurance)


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We thank two anonymous reviewers for their valuable comments on the paper.

This research was supported by Lilly Germany GmbH, Bad Homburg.

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Correspondence to Lusine Breitscheidel.

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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).

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  • Diabetes
  • Type 1 diabetes
  • Type 2 diabetes
  • Retinopathy
  • Costs