Table 3 Evaluation of direct and indirect costs associated with CSU

Data sources

 • Medical record abstraction form

 • Patient survey

Unit costs

 Country-specific unit cost estimates will be applied where available, using standard national sources, e.g.,

 • UK National Health Service Reference Costs

 • German Einheitlicher Bewertungsmaßstab (Uniform Rating Scale)

 • National drug formularies

 • National average wage statistics

Direct health care costs (all CSU-related)

 • Physician visits, including private practice visits

 • Emergency room visits

 • Hospitalizations

 • Therapies (including drugs, alternative medicine and out-of-pocket expenses)

 • Laboratory tests

 • Transportation costs

Indirect costs (employed patients; CSU-related)

 • Lost productivity due to sick leave and early retirement (analyzed using the friction cost approach)

 • Reduced productivity due to reduced performance at work (presenteeism)