[Cost-of-illness Study for the Treatment of COPD in Germany]. / Krankheitskosten von COPD in Deutschland.

The present cost-of-illness study is focused on the costs of COPD in Germany. In a pre-study, data on 814 randomly selected patients were collected to achieve reliable figures for the distribution of COPD severity grades and the frequencies of exacerbations. The main study was performed on 321 randomly selected patients from the pre-study. Data on resource use were collected in a face-to-face interview with the respective physicians using the patient records as a basis. Costs associated with resource consumption were weighted with the frequencies of COPD severity grades as assessed in the pre-study to determine the costs of COPD. Annual COPD-related costs per patient were 3,027 from the societal perspective. Main cost components were hospitalisations (26 %), medication (23 %) and early retirement (17 %). Annual COPD-related costs from the perspective of the German health insurance system (GKV) were 1,944 euros per patient.

[Managed care--chances for health care in Germany?]. / Managed Care--Chancen für das Gesundheitswesen in Deutschland?

The incentives offered by the German health insurance make it rational for doctors and patients to adopt uneconomical attitudes that militate against the objective of providing economical health care tailored to individual needs. Managed care systems are a means of correcting this undesirable state of affairs. Implementation of managed care in Germany would however, appear to make good sense only when it is offered as a competitive alternative that guarantees the freedom of action and choice of all those involved.