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Identification of Unit Costs in Rheumatoid Arthritis
Research Approach and Results
Rosery H., Schwander B., Bergemann R.
IMOR - Institute for Medical Outcome Research GmbH
Untere Herrenstrasse 25, 79539 Loerrach, Germany
www.imor.com
ISPOR
ISPOR
6th
6thAnnual
AnnualEuropean
EuropeanCongress
Congress
PMD23
PMD23
Methods
Objective
In the context of a multi-center trial resource consumption of patients with
rheumatoid arthritis was assessed using investigator and patient
To elaborate a useful level of detail according to measurement and
valuation of costs associated with rheumatoid arthritis.
questionnaires. Resources were gathered as amounts and not as costs.
An intensive Internet Research was performed to assess country -specific
unit costs.
Structure of Cost Data
Cost Research Documentation
TOTAL
LEVEL 1
LEVEL 2
LEVEL 3
DIRECT
OUTPATIENT
INPATIENT
LEVEL 4
LEVEL 5
LEVEL 6
INDIRECT
DIRECT MEDICAL
HOSP
1
DIRECT NONMEDICAL
REHA
Doctor
Medication
Specific
Procedure
Other
Treatments
Technical
work and
Aids
Personal
Help
Transpor tation
Unfit
for
work
1
3
2
11
7
16
5
7
1
We reported the type of cost item, country, total costs of one unit, name
of data source, date of data, homepage address, date of review,
calculation assumption and calculation method.
Unit costs were assessed for ten cost domains: Doctor visit, medication,
diagnostic procedures, monitoring, hospitalization, rehabilitation,
personal help, stoppage, traveling and other treatments.
Example of Unit Cost Values of 3 Cost Domains for 5 Countries
Australia
Canada
France
Germany
Great Britain
Cost item
Unit costs Unit costs Unit Costs Unit costs Unit Costs Unit costs Unit costs Unit costs Unit Costs Unit costs
AUD
USD
CAD
USD
FF
USD
DEM
USD
GBP
USD
Doctor visits
Visits of general practitioner
20.33
11.82
41.96
28.28
115.00
26.81
33.58
15.86
26.75
40.54
Visits of other doctor
68.66
39.91
51.92
34.99
150.00
34.97
33.58
15.86
63.50
96.23
Outpatient department visit
44.49
25.86
46.32
31.21
132.50
30.89
33.58
15.86
45.13
68.39
Hospitalization Hospitalization per day
628.58
365.38
623.00
419.82
1732.40
403.85
568.00
268.23
258.50
391.73
Rehabilitation Rehabilitation per day
519.12
301.76
378.50
255.06
1093.00
254.80
212.95
100.56
169.00
256.10
Currency exchange rate*: 1 AUD = 0.581283 USD
1 CAD = 0.673865 USD
1 FF = 0.233117 USD
1 DEM = 0.472237 USD
1 GBP = 1.51539 USD
*Reference: European Central Bank 2000, yearly average
The evaluation was performed for the 5 countries: Australia, Canada, France, Germany, and Great
Britain.
All unit costs were given in national currency as well as US$ for comparative purposes .
Results
Conclusion
• Unit costs – understood as multiplicative part of costs as product of
• Significant differences in values of unit costs were identified with the
Internet research. The country -specific values of comparative unit costs
differed a lot.
• England and Australia show high differences of unit costs values per
type of doctor visit. All five countries have high variances within the
different diagnostic procedures, the kind of personal help and the type
of traveling. The most differential references for the evaluation of
medication costs were found in Germany.
price – have a substantial impact on health economic
difference by country.
amount and
evaluations and the
• In general the identification of unit costs has to adapt the specific
payment
systems of health care. It is non- permissible to transfer countryspecific results to
other countries.
• Because the amount of unit costs differs a lot each health economic
study report
has to explain and document the used calculation approach. Otherwise the user is
unable to prove the robustness of data.
Additionally, the performance of
sensitivity analysis is aggravated.