SP7: Health Economics

Health economic data on the medical care for patients with malignant lymphomas in Germany are scarce. Although of considerable health political relevance, neither the direct medical costs nor the indirect societal costs of malignant lymphomas are sufficiently known. The aims of this subproject were to assess the clinical benefits and costs of treatments of patients with newly diagnosed malignant lymphomas.

Together with subproject 6, the project formed part of the “Cologne and Saarland lymphoma project”. The data used in both subprojects were collected prospectively, mainly by means of a patient notebook and a health economic questionnaire. Health economic evaluations of the data were performed focusing on three main factors influencing the treatment: (1) inpatient versus outpatient treatment (2) routine treatment versus clinical trial protocols (3) treatment by a specialised hematologist/oncologist or not. Clinical outcomes were: The primary result of therapy, the frequency of relapse and overall survival of patients. Hospital costs and costs of chemotherapy during the first 6 months after initial diagnosis were calculated. Costs of ambulant care were determined by health economic modelling.

On the basis of these analyses, the cost-effectiveness of typical patterns of care have been evaluated. The aim was to find ways of optimising the care of lymphoma patients, thus reducing the treatment costs while at least maintaining the quality of care. Finally, clinical pathways and guidelines for the treatment of patients with malignant lymphomas have to be drawn up in cooperation with clinical trial groups and sickness funds.

Health economically relevant resource use items have been identified and incorporated into the patient book in a user-friendly manner. Costing tools specifically designed for the treatment of patients with malignant lymphomas have been developed for the perspectives of payers, hospitals and society. A methodology for the development of clinical pathways and guidelines has been developed and reported (see above). The role of the Competence Network and, in particular, of this subproject, for quality management in the German health care sector has been evaluated and reported. The cost of illness study has been completed.

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