Life time cost of coronary heart disease in Germany - A study from the perspective of society

Cardiovascular diseases an the major cause of death not only in Germany. Co ronary heart diseases result in substantial disability and loss of producti vity and contribute to escalating costs of health care. Objective: It was o ur objective to estimate the costs of CHD for the German population from th e perspective of the society. The characteristic of this approach is the ca lculating of casts until the approximated end of life. Methods: In the stud y, all health carl costs concerning CHD in Germany were allocated to age, s ex, health care sector and primary diagnosis on the basis of comprehensive data on morbidity, mortality, direct and indirect costs. For the estimate o f indirect costs the human capital approach was taken. Considered as cases were all patients hospitalized in the reference year (1996). The costs of t his cohort in 1996 and up to their protected end of life were estimated. It was taken into account that, in comparison to the general population, life expectancy of cases with risk factors or CHD would have been reduced. In c alculating indirect costs, gender and age specific unemployment rates were considered. All future costs were discounted by 4 % from the reference year onward. Results: Direct costs are approximately 39 billion DM discounted a t 4 %, indirect costs total 73 billion DM. The average cost per case (inclu ding morbidity and mortality) until the approximated end of life is nearly 125,000 DM. Conclusion: In our cost analysis, the indirect costs are higher than the direct costs. For the future, it will be important to estimate th e costs of prevalent cases until the end of life and to compare the influen ce of different interventions on these parameters and on the whole budget o f the social security system.