The health economic burden of dengue in Germany: a retrospective analysis of statutory health insurance claims data

Abstract

Background

Dengue is a mosquito-borne disease primarily affecting tropical and subtropical regions. Due to climate change, spread of Aedes albopictus into Europe, and increased global travel, concern about dengue’s burden in non-endemic countries has been growing. This study describes the health economic burden of dengue in Germany from the perspective of Statutory Health Insurance (SHI).

Methods

A retrospective data analysis using an anonymized SHI claims database representing 11.0 % of the German SHI population was conducted; 440 dengue patients diagnosed between January 1st, 2015, and December 31st, 2018 were identified using ICD-10-GM codes. Propensity scoring matched cases to controls. Healthcare resource utilization and costs in the year following diagnosis were compared.

Results

One-year administrative incidence rate of dengue ranged from 1.4 to 1.7 per 100,000 individuals. Cases tended to be young (50.0 % were 18–34 years old), urban (69.1 %) individuals from southwestern Germany (60.7 %). Almost all cases were non-severe. Compared to controls, dengue patients had significantly higher healthcare resource utilization, including 3.2 times higher probability of being hospitalized, 8.2 more outpatient visits, and 9.5 additional sick leave days (all p < 0.001). Costs for total healthcare (€769.8), inpatient (€237.3) and outpatient (€368.6) care also increased significantly (all p < 0.001). Inpatient costs accounted for 50.1 % of total costs.

Conclusion

Dengue poses a sizable health economic burden in Germany in the year following diagnosis as it increases healthcare resource utilization, sick leave days, and healthcare-related costs compared to individuals without dengue. The findings highlight the need for targeted public health interventions to mitigate the impact of dengue.