Cost of atherothrombotic diseases-myocardial infarction, ischaemic stroke and peripheral arterial occlusive disease-in Germany

Aim As of January 2004, a new DRG (diagnosis related groups) based system has been introduced for the reimbursement of hospital services in Germany. As current data on the treatment cost of patients with myocardial infarction (MI), ischaemic stroke (IS), and peripheral arterial occlusive disease (PAD) are lacking from the third-party payer's perspective, a bottom-up cost analysis was conducted as a first approach to show treatment cost, based on the DRG system. Subjects and methods The evaluation is focused on patients who are hospitalized for an initial cardiovascular event, such as MI, IS or PAD. In order to describe the resource utilization following an initial event owing to MI, IS and PAD, an expert panel was convened in 1997, which included cardiologists, neurologists, angiologists, internists and general practitioners (GP). To update the 1997 expert panel resource utilization data, four specialists for atherothrombotic diseases in Germany were interviewed in 2004. Prices and charges for drugs and medical services were adapted to the current payment system. Annual costs and costs for a subsequent 6-month period were calculated. Results Patients with MI incurred on average 11,672 EUR in the first year after the initial event and 981 EUR in the subsequent 6-month period. Annual costs in the first year in patients with IS and PAD were 17,864 EUR and 7,674 EUR, respectively. Treatment costs for the subsequent 6-month period were 5,280 EUR in IS patients and 1,172 EUR in PAD patients. Conclusion This is a first approach to outline the longitudinal dimension of treatment costs from the third-party payer's perspective in patients with MI, IS and PAD, based on the DRG system in Germany. The evaluation provides basic data for further decision-making, including assessment of treatment strategies for MI, IS and PAD in Germany.