VENOUS DISEASE - THE NEW INTERNATIONAL CHALLENGE

This paper reviews data on the socio-economic aspects of venous diseas e and venous insufficiency. It will cover data on the burden of diseas e and the effects of venous insufficiency on quality of life. It will also cover varicose veins, chronic venous insufficiency and venous ulc ers of the leg. The use of the WHO International Classification of Dis eases allows for comparisons across countries, with costs expressed no t only in local currency, but also in terms of ECUs and as a percentag e of health care costs. The paper presents estimates on the costs of v enous disease in the UK, France and Germany. Using standard diagnoses, costs are estimated to amount to 1.5-2.0% of total health care expend iture in these three countries. This is divided between inpatient, out patient and community nursing programmes. Prescribing costs for venous diseases range from 0.26% of the total in the UK to 5.38% in France, with Germany in the middle of the range at 2.87%. The paper also summa rizes costs in terms of reduced quality of life and loss of work-time. In Germany venous diseases contributed significantly to total disabil ity, accounting for 1.2% of invalidity days in the late 1980s. As a re sult of dissatisfaction with current treatment programmes there have b een moves towards new ones. The paper sets out the evidence on innovat ions in care through investment programmes aimed at reducing costs and improving efficacy. Current developments in Britain, Germany and Fran ce are set out, summarizing likely costs and benefits.