First EFIC® Symposium Societal Impact of Pain - SIP

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Cornelius Erbe
Dr. Cornelius Erbe
Member of the Extended Board -
Head of Product Management
D A K - Unternehmen Leben
Dr. Cornelius Erbe is currently holding a position
as senior vice president and member of the
extended Board of Deutsche Angestellten-
Krankenkasse (DAK); Hamburg/Germany. DAK
is the third largest German statutory health
insurance organization with 4.8 million members
and 6.3 million insured persons. Dr. Erbe
is head of Product Management and is responsible
for developing and contracting all medical
and paramedical services for DAK’s members.
Previously, Dr. Erbe held positions as a partner
at Roland Berger Strategy Consultants, and as
a product manager for diabetes pharmaceuticals
at Boehringer Mannheim, Mannheim/Germany.
Dr. Erbe studied medicine at Albert-Ludwigs-University,
Freiburg/Germany.
Analyses of types and costs of pain - based
on 6 million insured persons
In the past the treatment of patients with
chronic pain has rarely been studied in large
populations. Thus little is known about the frequency
of pain associated with various underlying
conditions, the cost incurred when caring
for patients with chronic pain and the effectiveness
of various interventions.
Past analyses focused on selected patient
groups and the care of patients with chronic
pain from the perspective of a third-party payer
offering comprehensive health care coverage
has not been studied. One main reason for this
lack of studies is the fact that the ICD-10 (In-
ternational Statistical Classification of Diseases
and Related Health Problems 10th Revision)
does not provide the codes necessary to classify
pain. Thus patients with chronic pain, at
least until 2009, could not be identified via ICD-
10 diagnostic codes.
In a cooperative health services research project
IGES Institut (Berlin), Grünenthal GmbH
(Aachen), and DAK – Unternehmen Leben
(Hamburg) developed a novel algorithm to identify
patients using health insurance claims data.
DAK – Unternehmen Leben is the third largest
statutory health insurance in Germany covering
about 6.2 million individuals.
Within this population the study identified patients
with pain, classified various types of pain
and analysed treatment costs from the perspective
of a third-party payer.
The algorithm used to identify patients and the
approach to classify different types of pain will
be presented. Two methods of allocating treatment
costs will be discussed highlighting their
respective strengths and limitations. Results
will be shown for the subgroup of patients with
back pain with respect to prescribed drugs as
well as the main cost drivers.
Attempts will be made to interpret different
levels of costs observed at different stages in
the course of the disease. These results offer
new starting points for the prevention of
chronicity and consequently also for the reduction
of costs.
This investigation constitutes a milestone in
the study of pain under the conditions of routine
care and serves as a new empirical foundation
for discussions on the proper identification of
patients eligible for managed care programs
aimed at increasing treatment efficiency and
reducing costs through adaequate, stageadjusted
care.