Skip to main content

Advertisement

SpringerLink
Log in

Cost of illness in patients with Gilles de la Tourette’s syndrome

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

We evaluated the health economic burden of patients with Gilles de la Tourette’s syndrome (GTS) in Germany over a 3-month observation period. Direct and indirect costs were evaluated in 200 outpatients with GTS (mean age 35 ± 11.5 years) in Germany. Patients were recruited from three outpatient departments that specialized in GTS and completed a semi-structured and self-rating interview with questionnaires screening for direct and indirect medical and non-medical costs, health status, depression, amount and severity of symptoms. Costs were obtained from various German medical economic resources. Indirect costs for lost productivity were calculated using the human capital approach. Costs were calculated from the point of view of healthcare and transfer payment providers and the individual patient. Multivariate regression analyses were performed to identify independent cost predictors. Costs are in year 2006–2007 values. Direct costs were 620 ± 1,697.1€, including rehabilitation 98.8 ± 993.6€, hospitalization 195.8 ± 1,267.8€, outpatient treatment 14.0 ± 40.6€, ancillary treatment 51.9 ± 137.4€. Drug costs were 223.1 ± 430.4. The indirect medical costs amounted to 2,511.3 ± 3,809.5€ for productivity loss and to 220.0 ± 1,092€ for absenteeism. The following variables were found to impact on direct costs: employment status, occupational advancement, depression, quality of life, age. Disease severity had no influence on cost. Because of the earlier age of disease onset, indirect costs are higher than direct costs. Interestingly, disease severity did not influence the resource need in this population. Unfortunately, no cost of illness studies are available for comparison. Further health economic studies, especially cost-effectiveness studies, are necessary for a basis for rational resource allocation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barber JA, Thompson SG (2000) Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med 19:3219–3236

    Article  CAS  PubMed  Google Scholar 

  2. Bernard BA, Stebbins GT, Siegel S, Schultz TM, Hays C, Morrissey MJ, Leurgans S, Goetz CG (2009) Determinants of quality of life in children with Gilles de la Tourette syndrome. Mov Disord 24:1070–1073

    Article  PubMed  Google Scholar 

  3. Bloch MH, Peterson BS, Scahill L, Otka J, Katsovich L, Zhang H, Leckman JF (2006) Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome. Arch Pediatr Adolesc Med 160:65–69

    Article  PubMed  Google Scholar 

  4. Centers for Disease Control and Prevention (2009) Prevalence of diagnosed Tourette syndrome in persons aged 6–17 years—United States, 2007. MMWR Morb Mortal Wkly Rep 58:581–585

    Google Scholar 

  5. Cohen D, Leckmann J, Shaywitz B (1985) Tourette syndrome. In: Shaffer D, Ehrhardt AA, Greenhill LL (eds) The clinical guide to child psychiatry. The Free Press, New York, pp 3–28

    Google Scholar 

  6. Cutler D, Murphy T, Gilmour J, Heyman I (2009) The quality of life of young people with Tourette syndrome. Child Care Health Dev 35:496–504

    Article  CAS  PubMed  Google Scholar 

  7. Elstner K, Selai CE, Trimble MR, Robertson MM (2001) Quality of life (QOL) of patients with Gilles de la Tourette’s syndrome. Acta Psychiatr Scand 103:52–59

    Article  CAS  PubMed  Google Scholar 

  8. EuroQuol Group (1990) EuroQuol: a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Article  Google Scholar 

  9. Graf von der Schulenburg JM, Greiner W, Jost F, Klusen N, Leidl R, Mittendorf T, Rebscher H, Schöffski O, Vauth C, Volmer T, Wahler S, Wasem J, Weber C, und die Mitglieder des Hannoveraner Konsens (2007) German recommendations on health economic evaluation—third updated version of the Hanover Consensus. Gesundh ökon Qual Manag 12:285–290

  10. Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, Buxton M, Dolan P, Kind P, Krabbe P, Ohinmaa A, Parkin D, Roset M, Sintonen H, Tsuchiya A, de Charro F (2003) A single European currency for EQ-5D health states. Results from a six-country study. Eur J Health Econ 4:222–231

    Article  PubMed  Google Scholar 

  11. Hamer HM, Spottke A, Aletsee C, Knake S, Reis J, Strzelczyk A, Oertel WH, Rosenow F, Dodel R (2006) Direct and indirect costs of refractory epilepsy in a tertiary epilepsy center in Germany. Epilepsia 47:2165–2172

    Article  PubMed  Google Scholar 

  12. Happe S, Reese JP, Stiasny-Kolster K, Peglau I, Mayer G, Klotsche J, Giani G, Geraedts M, Trenkwalder C, Dodel R (2009) Assessing health-related quality of life in patients with restless legs syndrome. Sleep Med 10(3):295–305

    Article  PubMed  Google Scholar 

  13. Hautzinger M, Bailer M, Worall H, Keller F (2005) Beck-Depressions-Inventar (BDI). Testhandbuch, Hans Huber Verlag

    Google Scholar 

  14. John A, Wienemann G, Reese JP, Wellek A, Bv Hagen, Dodel R, Tackenberg B, Balzer-Geldsetzer M (2009) Longitudinale Studie zu Lebensqualität und Versorgung bei Patienten mit Multipler Sklerose. Akt Neurologie 16:S 02

    Google Scholar 

  15. König H, Bernert S, Angermeyer M (2005) Gesundheitszustand der deutschen Bevölkerung: Ergebnisse einer repräsentativen Befragung mit dem EuroQol-Instrument. Gesundheitswesen 67:173–182

    Article  PubMed  Google Scholar 

  16. Koopmanschap MA, Rutten FFH, van Ineveld BM, van Roijen L (1995) The friction cost method for measuring indirect costs of disease. J Health Econ 14:171–189

    Article  CAS  PubMed  Google Scholar 

  17. Krauth C, Hessel F, Hansmeier T, Wasem J, Seitz R, Schweikert B (2005) Empirische Bewertungssätze in der gesundheitsökonomischen Evaluation- Ein Vorschlag der AG Methoden der gesundheitsökonomischen Evaluation (AG MEG). Gesundheitswesen 67:736–746

    Article  CAS  PubMed  Google Scholar 

  18. Leckman JF, Towbin KE, Ort S, Cohen DJ (1988) Clinical assessment of tic disorder severity. In: Cohen DJ (ed) Tourette’s syndrome and tic disorders: clinical understanding and treatment. Wiley, New York, pp 55–79

    Google Scholar 

  19. Rindner EC (2007) Living with Tourette’s syndrome. J Psychosoc Nurs Ment Health Serv 45:19–23

    PubMed  Google Scholar 

  20. Robertson MM (2008) The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 1: the epidemiological and prevalence studies. J Psychosom Res 65:461–472

    Article  PubMed  Google Scholar 

  21. Robertson MM (2008) The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 2: tentative explanations for differing prevalence figures in GTS, including the possible effects of psychopathology, aetiology, cultural differences, and differing phenotypes. J Psychosom Res 65:473–486

    Article  PubMed  Google Scholar 

  22. Rote Liste (2006) Arzneimittelverzeichnis für Deutschland Rote Liste® Service GmbH, Frankfurt/Main

  23. Spottke AE, Reuter M, Machat O, Bornschein B, von Campenhausen S, Berger K, Koehne-Volland R, Rieke J, Simonow A, Brandstaedter D, Siebert U, Oertel WH, Ulm G, Dodel R (2005) Cost of illness and its predictors for Parkinson’s disease in Germany. Pharmacoeconomics 23:817–836

    Article  PubMed  Google Scholar 

  24. Statistisches Bundesamt (2007) Statististisches Jahrbuch

  25. Stern JS, Burza S, Robertson MM (2005) Gilles de la Tourette’s syndrome and its impact in the UK. Postgrad Med J 81:12–19

    Article  CAS  PubMed  Google Scholar 

  26. Storch EA, Merlo LJ, Lack C, Milsom VA, Geffken GR, Goodman WK, Murphy TK (2007) Quality of life in youth with Tourette’s syndrome and chronic tic disorder. J Clin Child Adolesc Psychol 36:217–227

    PubMed  Google Scholar 

  27. Thümler EK (2005) Der Zusammenhang zwischen dem Selbstwert und der Ticstärke in sozialen Situationen beim Tourette-Syndrom. In: Institut für Psychologie. Martin-Luther-Universität, Halle-Wittenberg, p 106

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany

    Ines Dodel, Jens Peter Reese, Monika Balzer-Geldsetzer, Wolfgang H. Oertel & Richard Dodel

  2. Department of Psychiatry, Ludwig-Maximilians University Munich, Munich, Germany

    Norbert Müller

  3. Department of Neurology, University Hamburg Eppendorf, Hamburg, Germany

    Alexander Münchau

  4. Lehrstuhl für Medizinmangement, University Duisburg-Essen, Essen, Germany

    Jürgen Wasem

  5. Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany

    Kirsten Müller-Vahl

Authors
  1. Ines Dodel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jens Peter Reese
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Norbert Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexander Münchau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Monika Balzer-Geldsetzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jürgen Wasem
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wolfgang H. Oertel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Richard Dodel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kirsten Müller-Vahl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard Dodel.

Additional information

I. Dodel and J. P. Reese contributed equally.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dodel, I., Reese, J.P., Müller, N. et al. Cost of illness in patients with Gilles de la Tourette’s syndrome. J Neurol 257, 1055–1061 (2010). https://doi.org/10.1007/s00415-010-5458-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-010-5458-y

Keywords

Search

Navigation