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How expensive are post-traumatic stress disorders? Estimating incremental health care and economic costs on anonymised claims data


  • Tim Bothe

    (Technical University of Brunswick
    InGef – Institute for Applied Health Research Berlin)

  • Josephine Jacob

    (InGef – Institute for Applied Health Research Berlin)

  • Christoph Kröger

    (University of Hildesheim)

  • Jochen Walker

    (InGef – Institute for Applied Health Research Berlin)


Background Post-traumatic stress disorders (PTSD) pose a high burden for individuals and societies. Although prevalence rates are rather low, high co-occurrence rates and overall impairments cause deleterious suffering and significant costs. Still, no long-term data on costs and trends in cost developments are available. Methods Claims data from a German research database were analysed regarding direct and indirect costs occurring for individuals with incident diagnoses of PTSD. Results were compared to non-exposed average insurants matched on age and gender. Costs were analysed over a 5-year period from 2 years preceding until 3 years following an incident diagnosis of PTSD. Results Overall costs for PTSD account for approximately 43,000 EUR per individual, which is three times higher than costs for non-exposed controls. Of these costs, 59% are caused by mental disorders, 18% specifically by PTSD. In the control group, costs for mental disorders account for 19% of total costs. Costs increase by 142% in the year after an incident diagnosis of PTSD but return to the initial level 2 years later. Still, costs are at least twice as high in every year as in those for the comparison group. Conclusions Individuals with PTSD seem to suffer from far more impairments in their general health conditions and incur many more costs than average insurants. Most of these seem to be caused by co-occurring mental disorders and show their maximum in the index year. Nevertheless, as costs decrease to their initial level, treatments seem to have counterbalanced the impairments due to PTSD. Thus, treatments for PTSD can be considered as beneficial and their cost-effectiveness should be further investigated.

Suggested Citation

  • Tim Bothe & Josephine Jacob & Christoph Kröger & Jochen Walker, 2020. "How expensive are post-traumatic stress disorders? Estimating incremental health care and economic costs on anonymised claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(6), pages 917-930, August.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:6:d:10.1007_s10198-020-01184-x
    DOI: 10.1007/s10198-020-01184-x

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    References listed on IDEAS

    1. R. Laynard & D. Clark & M. Knapp & G. Mayraz, 2007. "Cost-benefit analysis of psychological therapy," National Institute Economic Review, National Institute of Economic and Social Research, vol. 202(1), pages 90-98, October.
    2. Katharina Bode & Rolf Vogel & Jochen Walker & Christoph Kröger, 2017. "Health care costs of borderline personality disorder and matched controls with major depressive disorder: a comparative study based on anonymized claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1125-1135, December.
    3. Layard, R. & Clark, D. & Knapp, M. & Mayraz, G., 2007. "Cost-benefit analysis of psychological therapy," National Institute Economic Review, Cambridge University Press, vol. 202, pages 90-98, October.
    4. Valentin Amrhein & Sander Greenland & Blake McShane, 2019. "Scientists rise up against statistical significance," Nature, Nature, vol. 567(7748), pages 305-307, March.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 3rd August 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-08-03 11:00:00

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    More about this item


    Post-traumatic stress disorders; Health care costs; Claims data; Cost-analysis; Cost-comparison;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other


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