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Diabetes mellitus has become a widespread disease in Germany. There are at least 7 million people with diagnosed diabetes mellitus in Germany and, taking into account the undiagnosed cases and the increasing prevalence of the disease worldwide, especially among younger people, the German health system will face major challenges, including economic ones. Under certain conditions, self-monitoring of blood sugar can be a very useful and cost-effective therapeutic element in the treatment of the disease. Although this benefit in insulin-dependent diabetics is largely undisputed, there is still no consensus in Germany about the benefit in non-insulin-dependent type 2 diabetics. However, what is often overlooked in the benefit assessment is that self-measurement of blood glucose is a diagnostic procedure which – unlike medicines – cannot have an intrinsic effect. Applying drug evaluation methods to a diagnostic procedure can subsequently lead to misleading results. If blood glucose measurement is used correctly by patients and appropriate assessment methods are used, self-assessment of blood glucose in type 2 patients even proves to be cost-saving for health insurance companies.
01.04.2009
Prof. Dr. Wolf-Dieter Ludwig, Vorsitzender der Arzneimittelkommission der deutschen Ärzteschaft, im MVF-Titelinterview
01.03.2009
Since 2002, the market for narcotic analgesics has more than doubled
01.03.2009
Das von dem Burscheider Institut für empirische Gesundheitsökonomie (Ifeg) erarbeitete Gutachten belegt eine erhebliche Unterversorgung bei der Behandlung der rheumatoiden Arthritis (RA). Eine Unterversorgungsquote von 69 % wurde konstatiert. Dabei wurde von einer Prävalenzrate von 0,5 % ausgegangen. Diese Unterversorgung ist eng verknüpft mit dem Mangel an internistischen Rheumatologen in der ambulanten Versorgung, der auch […]
01.03.2009
Health management services are knowledge-based services. They can be used in different care settings and in different phases of the indication-specific disease progression. A distinction is made between selective, periodic to sequential and continuous HMS interventions. The instruments start with simple reminder or e-mail educational services (Infocept), lead through more data- and technology-driven call centers or risk assessments to personnel-intensive offers such as case or disease management programs. In the future, personal health coaching and behavior modification will become more important if you really want to achieve sustainability. The costs for HMS instruments and programs range between 5 euros and 2,000 euros per intervention or year. The benefit lies in improved medical outcomes. Financing can be provided by cost bearers, service providers, product providers, additional insurance or personal contributions.
01.03.2009
With the most recent health care reform (GKV-WSG), the tasks of the Institute for Quality and Efficiency in Health Care (IQWiG) were expanded: Previously, it could only evaluate drugs with regard to their medical benefits. In the future, the institute should also put the costs of the medication in relation to the previously determined benefits. According to the law, these cost-benefit assessments are intended, on the one hand, to set maximum amounts for certain medications. On the other hand, they can support the Federal Joint Committee (G-BA) in assessing the cost-effectiveness of medical procedures. The proposed concept favors “efficient frontier analysis” as a method. The second element is a “budget impact analysis” to estimate how decisions affect healthcare spending.
01.03.2009
Cost-effectiveness analysis has experienced enormous growth in recent years as an aid to decision-making. Their legal anchoring in the performance audit means that the reliability of the statements must be checked. Political and methodological skepticism is particularly directed against a simple decision based on the monetary costs per QALY of a therapy. The discussion is also growing as to whether subjective assessments of benefits by individuals should take precedence over objective assessments of a group. It is still unclear which controls will ultimately be chosen in the healthcare system. However, both approaches require methodological refinement before they can offer helpful support to health policy.
01.03.2009
In the course of the Europeanization of the healthcare system, interest in healthcare system comparisons has also increased noticeably. Looking beyond one's own health policy inevitably enables the strategic further development of best-practice approaches in the health sector. The instruments of the open method of coordination (OMK) adopted by the EU are proving to be a creative driving force in the development of a Europe-wide comparison of health systems. Health policy reform processes triggered by this should also undergo a regular controlling process at the health care level, which requires the targeted methodical use of health care research. As a result, a European model of health services research could be on the health policy agenda in the foreseeable future.
01.03.2009
The “Aut-idem” regulation and the discount agreements according to Section 130a Paragraph 8 SGB V are among the most important regulatory measures regarding pharmaceutical expenditure by statutory health insurance. Both measures aim to replace patent-free original preparations with cheaper preparations with the same active ingredients, so-called generics. However, preparations with the same active ingredients are not necessarily identical to the original due to the use of other excipients and carriers as well as the permitted tolerances for the active ingredients. Exchanging the preparation can have a negative impact on the course of diseases with a narrow therapeutic range, such as epilepsy, due to these tolerances. In this case, recurrent epileptic seizures can mean that the replacement does not save any costs, but rather generates additional expenses. Epilepsy is therefore an indication in which value-added contracts should be concluded instead of discount tenders. These focus not only on cost savings, but also on optimizing patient care.
17.12.2008
The study presented here examines the preferences of members of the German statutory health insurance (GKV) with regard to modern insulin therapy for diabetics. The central question was: Should the long-acting insulin analogue continue to be paid for by the statutory health insurance? The health economics answer is simple. If the willingness to pay of even those people who do not rely on insulin exceeds the additional costs of the new preparation, there is no reason why the GKV should not reimburse it. If their willingness to pay is lower than the additional costs, the patients themselves in the form of an additional payment could still be sufficient to cover the additional costs. With a so-called market experiment, the preferences were determined in 2007 by surveying 1,100 GKV insured people (500 of whom were diabetics). The results show: Not only diabetics treated with insulin, but also those who only need an oral medication, as well as non-diabetics, derive additional benefit from “Insulindetemir” compared to human insulin. Although non-diabetics in particular prefer financing through co-payment, their willingness to pay through an increased statutory health insurance contribution is so high that it exceeds the additional costs compared to treatment with human insulin. Therefore, based on this cost-benefit analysis, nothing stands in the way of financing the drug “Insulindetemir” by the GKV.