Cost-of-illness studies in nine Central and Eastern European countries

Eur J Health Econ. 2019 Jun;20(Suppl 1):155-172. doi: 10.1007/s10198-019-01066-x. Epub 2019 May 18.

Abstract

Background: To date, a multi-country review evaluating the cost-of-illness (COI) studies from the Central and Eastern European (CEE) region has not yet been published. Our main objective was to provide a general description about published COI studies from CEE.

Methods: A systematic search was performed between 1 January 2006 and 1 June 2017 in Medline, EMBASE, The Cochrane Library, CINAHL, and Web of Science to identify all relevant COI studies from nine CEE countries. COI studies reporting costs without any restrictions by age, co-morbidities, or treatment were included. Methodology, publication standards, and cost results were analysed.

Results: We identified 58 studies providing 83 country-specific COI results: Austria (n = 9), Bulgaria (n = 16), Croatia (n = 3), the Czech Republic (n = 10), Hungary (n = 24), Poland (n = 11), Romania (n = 3), Slovakia (n = 3), and Slovenia (n = 4). Endocrine, nutritional, and metabolic diseases (18%), neoplasms (12%), infections (11%), and neurological disorders (11%) were the most frequently studied clinical areas, and multiple sclerosis was the most commonly studied disease. Overall, 57 (98%) of the studies explicitly stated the source of resource use data, 45 (78%) the study perspective, 34 (64%) the costing method, and 24 (58%) reported at least one unit costs. Regardless of methodological differences, a positive relationship was observed between costs of diseases and countries' per capita GDP.

Conclusions: Cost-of-illness studies varied considerably in terms of methodology, publication practice, and clinical areas. Due to these heterogeneities, transferability of the COI results is limited across Central and Eastern European countries.

Keywords: Austria; Bulgaria; Central and Eastern Europe; Cost-of-illness; Croatia; Disease burden; Hungary; Poland; Romania; Slovakia; Slovenia; The Czech Republic.

Publication types

  • Systematic Review

MeSH terms

  • Cost of Illness*
  • Disease / economics*
  • Europe
  • Europe, Eastern
  • Humans
  • Models, Economic