Number of and mean costs among included CRC cases and controls overall and stratified by anatomical subsite classified into phase of care (the cost estimates are annualized as described in the methods section).

<p>Number of and mean costs among included CRC cases and controls overall and stratified by anatomical subsite classified into phase of care (the cost estimates are annualized as described in the methods section).</p

Estimating Colorectal Cancer Treatment Costs: A Pragmatic Approach Exemplified by Health Insurance Data from Germany

<div><p>Background</p><p>The cost of colorectal cancer (CRC) treatment is a crucial parameter to inform cost-effectiveness analyses on CRC screening but it is not readily available and therefore often lacking. We aimed to elaborate and exemplify a pragmatic approach to estimate CRC treatment cost based on health insurance data from Germany.</p><p>Methods</p><p>We included two groups of persons who were continuously health-insured between 2005–2010: A) Cases: Persons with a hospital discharge diagnosis of CRC (ICD C18–C20) between 2007–2010 and no such a diagnosis between 2005–2006 (to focus on incident CRC cases); B) Controls: Persons without a diagnosis of CRC during the observation period, matched to CRC cases by age and sex (matching factor: 1∶5). We considered in-patient, out-patient and drug costs and calculated incremental costs as the difference in means between cases and controls. We divided costs into three phases of care (initial, intermediate and end-of-life phase).</p><p>Results</p><p>The initial, the intermediate and the end-of-life phase included 12,792, 5,280, and 3,779 CRC cases, respectively, and 63,960, 26,400, and 18,895 controls. The mean incremental costs – annualized for each phase – were €26,000, €2,300, and €51,700, respectively. The costs of the initial phase of care were higher for rectal than for colon cancer. Annualized stage-specific cost estimates ranged from €15,000 to €21,300 for early stages and from €29,800 to €35,000 for late stages.</p><p>Conclusion</p><p>This pragmatic and feasible approach provided plausible estimates of CRC treatment costs in Germany; being transferable to other settings, it may thus facilitate to weigh up potential savings in treatment costs against the resources required for CRC control programs in various countries.</p></div

Additional file 1 of German mammography screening program: program sensitivity between 2010 and 2016 estimated based on German health claims data

Supplementary Material

Age-specific and age-standardized prevalence with 95% CIs (shaded area) of isotretinoin use per 1,000 girls and women aged 13–49 years between 2004 and 2019 in the GePaRD.

CI, confidence interval; GePaRD, German Pharmacoepidemiological Research Database.</p

Prescriptions of Isotretinoin dispensed to girls and women aged 13–49 years between 2004 and 2019 in GePaRD: Distribution of the specialty of the prescribing physician.

Prescriptions of Isotretinoin dispensed to girls and women aged 13–49 years between 2004 and 2019 in GePaRD: Distribution of the specialty of the prescribing physician.</p

Number of pregnancies exposed to isotretinoin between 2004 and 2019 in GePaRD by age group and year of beginning of pregnancy.

Number of pregnancies exposed to isotretinoin between 2004 and 2019 in GePaRD by age group and year of beginning of pregnancy.</p

STROBE Statement—checklist of items that should be included in reports of observational studies.

STROBE Statement—checklist of items that should be included in reports of observational studies.</p

Number of pregnancies exposed to isotretinoin between 2004 and 2019 in GePaRD, mother’s age at pregnancy beginning and type of pregnancy outcome: base case and sensitivity analyses considering delayed elimination (exposure window assigned to the last dispensation before pregnancy was extended by 1 month), a fixed supply of 30 days, and the possibility that lower or higher doses than the DDD for isotretinoin (30 mg) were used.

Number of pregnancies exposed to isotretinoin between 2004 and 2019 in GePaRD, mother’s age at pregnancy beginning and type of pregnancy outcome: base case and sensitivity analyses considering delayed elimination (exposure window assigned to the last dispensation before pregnancy was extended by 1 month), a fixed supply of 30 days, and the possibility that lower or higher doses than the DDD for isotretinoin (30 mg) were used.</p

Number of girls and women aged 13–49 years with at least 1 dispensation of isotretinoin between 2004 and 2019 in GePaRD by age group and year of prescription.

Number of girls and women aged 13–49 years with at least 1 dispensation of isotretinoin between 2004 and 2019 in GePaRD by age group and year of prescription.</p

Malformations observed in live-born children exposed to isotretinoin during pregnancy in GePaRD between 2004 and 2019.

Malformations observed in live-born children exposed to isotretinoin during pregnancy in GePaRD between 2004 and 2019.</p