Archive:
The age of the insured alone does not explain the highly varying levels of diabetes care
01.12.2009
Wolfram-Arnim Candidus, President of the German Society of Insured Persons and Patients (DGVP) in an interview with MVF
01.12.2009
Dr. Stefan Etgeton (Federal Consumer Organization Association) and Dr. Klaus Meyer-Lutterloh (DGbG) in an MVF interview
01.12.2009
The growing global burden of cancer demands a more productive and efficient process for developing new therapies. The relatively low attrition rates of molecularly targeted cancer therapies suggest that efforts to accelerate development must start with a strong foundation of data and consensus methods for identifying biomarkers associated with cancer progression and treatment response. In addition, work is needed to improve the efficiency and consistency of trials in identifying therapies that meaningfully improve outcomes. Delivering on the promise of 21st Century cancer care will require a collaborative effort that engages all stakeholders in the cancer community - researchers, product developers, regulators, and patients.
01.12.2009
In the German healthcare system, too, the inflexible and almost anti-performance remuneration systems in the outpatient and inpatient sectors are repeatedly criticized. In particular, thanks to the Expert Council for the Assessment of Developments in the Health Care System in 2007 and the activities of the National Association of Statutory Health Insurance Physicians, an increasing dynamic towards P4P can now also be observed in Germany. In this context, the regulations on selective contracts play a special role. It is actually only logical to reward those who perform above average and/or those who have improved significantly. Experience with concepts mainly comes from the USA and Great Britain. The first approach presented here as an example was developed by the Integrated Health Association (IHA), an association of various healthcare players, in California. Another innovative approach in the European discussion is the reorganization of general practitioner remuneration in Great Britain. However, the situation is fundamentally different than in the American models, as this involves the distribution of additional money based on performance. Although there are still no valid evaluation results, the Advisory Council (SVR) found positive results in 21 of 28 studies. Accordingly, P4P is one of the most important developments in the international discussion in recent years.
01.12.2009
The aim of the present analysis is to compare treatment costs between insulin-glargine and NPH-insulin-based therapies in patients with diabetes mellitus. Using a representative sample of health insurance data, simultaneous co-medication in the indication groups bolus insulin, oral antidiabetics, test strips and lancets/needles over three calendar years was determined for a total of six payers. During the analysis period (2006 - 2008), the aggregated absolute annual treatment costs per diabetes patient for insulin glargine-based therapies tended to be slightly below the costs of the respective NPH comparison groups. The analysis of the individual costs shows that the higher procurement costs for insulin glargine are overcompensated by savings in bolus insulin and test strip consumption. The present database analysis confirms the results of previously published health care research studies, according to which, from the perspective of statutory health insurance (GKV), there is a cost-neutrality between insulin glargine and NPH insulin-based treatment regimens under real care conditions.
01.12.2009
Since 2009, the health insurance companies that compete with each other for care have had to conclude common and uniform collective agreements for the remuneration of medical services on the basis of very narrow centralized guidelines. One way out of bringing innovation into care is to conclude individual health insurance selective contracts. At the same time, since 2009, all health insurance companies have been obliged to offer their insured persons particularly qualified family doctor-centered care on a voluntary basis. In order to prevent double financing of services, these selective contracts require an adjustment of the jointly and uniformly determined collective remuneration. The article shows which procedures are useful here in order to achieve a fair coexistence of collective system and selective contracts with the aim of innovation capability for the supply structures.
01.12.2009
The GKV pharmaceuticals market is currently under the mutual influence of central and selective contractual control instruments. This regulatory mix is characterized by a high degree of lack of transparency and regulatory incompatibilities. The discount contract system has also set in motion a development that, even in the medium term, endangers the viability of competition in various segments of the generics-capable market. In addition, negative effects on the quality of care have already been documented and are expected to become even greater in the future. Against this background, a model is outlined here that essentially establishes a corridor for GKV reimbursement prices that can be defined under therapeutic and competitive aspects, in which functional generic competition can develop. The approach takes up the idea of competition based on manufacturers' free pricing and puts this in the foreground. Political specifications for the methodology can ensure the - at least - expenditure-neutral transition from the current system to the alternative approach described. The design and implementation of the model takes into account the requirements for a simple and pragmatic solution for regulating the generic market, which is practically demonstrated by a feasibility study based on an indication group.
01.12.2009
Our healthcare system has a savings potential of at least 20, probably 25 % of its current volume, which consists of unnecessary procedures, interventions and operations, to a lesser extent unnecessary medicines, cures, administrative costs and much more. Rationing will eventually become unavoidable given demographic trends and advances in medicine that are leading to increasingly expensive procedures. However, this point in time can be significantly delayed by exhausting austerity measures.
01.12.2009
The head of IQWiG, Prof. Dr. med Peter T. Sawicki, in the MVF cover interview