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Productivity loss as a major component of disease-related costs in patients with hypercholesterolemia in Germany

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Abstract

Objective

Hypercholesterolemia is a common risk factor for cardiovascular diseases; however, there are only few data available on associated costs. The objective of this study is, therefore, to analyse direct and indirect costs in patients with hypercholesterolemia and to determine predictors of costs.

Methods

The ORBITAL Study is a randomised controlled trial evaluating the effectiveness of a compliance-enhancing program in patients with statin therapy. Consecutive patients eligible for statin therapy according to the Joint European Guidelines were enrolled nationwide in 1961 primary care practices in Germany. For the present cost-of-illness analysis, patients were asked retrospectively about medical resource use and employment status in the 6 months preceding enrolment. The perspective chosen was societal. Factors associated with costs were determined using linear regression.

Results

A total of 7,640 patients (56% men, mean age 60 ± 10 years, and 44% women, 64 ± 10 years) were included. Of these patients, 32% were employed, 17% had a history of myocardial infarction, 7% a history of stroke, 58% had hypertension, and 29% diabetes. Total disease-related costs amounted to a mean of 2,498 ± 4,898 Euros per patient over 6 months, comprising direct (44%) and indirect (56%) costs. Disease-related early retirement was responsible for 42% of costs, followed by hospital visits (19%), medication (15%), workdays lost (14%), physician visits (5%), outpatient therapy (2%), and rehabilitation (2%). In multivariable analyses, factors associated with direct costs included coronary interventions, risk stratum, and medical history. Factors associated with indirect costs included disease-related early retirement, other socio-economic and lifestyle factors, coronary interventions, risk stratum, and medical history.

Conclusion

The considerable economic burden associated with hypercholesterolemia indicates the need to assess long-term cost-effectiveness of health care programs in patients with this disorder.

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Acknowledgments

We would like to thank all participating investigators and patients for their cooperation. Ines Ziese, Verena Wölfert and Ulrike Stasun performed an excellent job with regard to study coordination and data management. The study was supported by a grant from AstraZeneca. Prof. Dr. Wegscheider had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author information

Authors and Affiliations

  1. Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, 10098, Berlin, Germany

    Jacqueline Müller-Nordhorn MD, DPH, Thomas Reinhold & Stefan N. Willich MD, MPH

  2. University of Applied Sciences, Munster, Germany

    Heike Englert PhD, MPH

  3. Department of Statistics and Econometrics, University of Hamburg, Hamburg, Germany

    Karl Wegscheider PhD

  4. University of Applied Sciences, Osnabruck, Germany

    Hendrike Berger PhD

  5. Cardiology Practice, Henstedt-Ulzburg, Germany

    Frank Sonntag MD

  6. Rehabilitation Center for Cardiovascular Diseases, Rudersdorf, Germany

    Heinz Völler MD

  7. AstraZeneca, Wedel, Sweden

    Wolfgang Meyer-Sabellek MD

  8. Department of Internal Medicine, University of Hamburg, Hamburg, Germany

    Eberhard Windler MD

  9. Department of Cardiology, University of Heidelberg, Heidelberg, Germany

    Hugo A. Katus MD

Authors
  1. Jacqueline Müller-Nordhorn MD, DPH
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  2. Heike Englert PhD, MPH
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  3. Karl Wegscheider PhD
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  4. Hendrike Berger PhD
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  5. Frank Sonntag MD
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  6. Heinz Völler MD
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  7. Wolfgang Meyer-Sabellek MD
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  8. Thomas Reinhold
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  9. Eberhard Windler MD
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  10. Hugo A. Katus MD
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  11. Stefan N. Willich MD, MPH
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Corresponding author

Correspondence to Jacqueline Müller-Nordhorn MD, DPH.

Additional information

ClinicalTrials.gov Identifier: NCT00379249.

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Müller-Nordhorn, J., Englert, H., Wegscheider, K. et al. Productivity loss as a major component of disease-related costs in patients with hypercholesterolemia in Germany. Clin Res Cardiol 97, 152–159 (2008). https://doi.org/10.1007/s00392-007-0602-0

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  • DOI: https://doi.org/10.1007/s00392-007-0602-0

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