Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and
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ORIGINAL PAPER
Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy J. Pöhlmann1 · K. Norrbacka2 · K. S. Boye3 · W. J. Valentine1 · H. Sapin4 Received: 19 December 2019 / Accepted: 26 August 2020 / Published online: 6 October 2020 © The Author(s) 2020
Abstract Background Health economic evaluations require cost data as key inputs. Many countries do not have standardized reference costs so costs used often vary between studies, thereby reducing transparency and transferability. The present review provided a comprehensive overview of cost sources and suggested unit costs for France, Germany and Italy, to support health economic evaluations in these countries, particularly in the field of diabetes. Methods A literature review was conducted across multiple databases to identify published unit costs and cost data sources for resource items commonly used in health economic evaluations of antidiabetic therapies. The quality of unit cost reporting was assessed with regard to comprehensiveness of cost reporting and referencing as well as accessibility of cost sources from published cost-effectiveness analyses (CEA) of antidiabetic medications. Results An overview of cost sources, including tariff and fee schedules as well as published estimates, was developed for France, Germany and Italy, covering primary and specialist outpatient care, emergency care, hospital treatment, pharmacy costs and lost productivity. Based on these sources, unit cost datasets were suggested for each country. The assessment of unit cost reporting showed that only 60% and 40% of CEAs reported unit costs and referenced them for all pharmacy items, respectively. Less than 20% of CEAs obtained all pharmacy costs from publicly available sources. Conclusions This review provides a comprehensive account of available costs and cost sources in France, Germany and Italy to support health economists and increase transparency in health economic evaluations in diabetes. Keywords Cost · Cost-effectiveness · Diabetes · France · Germany · Italy JEL Classification D61 · I10
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10198-020-01229-1) contains supplementary material, which is available to authorized users. * H. Sapin [email protected] 1
Ossian Health Economics and Communications, Basel, Switzerland
2
Eli Lilly Finland, Helsinki, Finland
3
Eli Lilly and Company, Indianapolis, IN, USA
4
Lilly France, 24 Bd Vital Bouhot, CS 50004, 92521 Neuilly‑sur‑Seine Cedex, France
Costs are key inputs into any health economic evaluation. Depending on the perspective and time horizon of the evaluation as well as available data, costs can be obtained from a variety of sources or calculated using several different approaches [1–5]. As discussed by Hoerger [6] in the context of cost-effectiveness modeling of diabetes, these costing approaches are neither standardized nor straightforward, so the choice of costs m
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