Faster COVID-19 treatment possible: Doctors demand guaranteed medication financing for clinics

09.08.2022 13:14

The utilization of corona patients in German clinics can be reduced significantly next winter if the federal government immediately starts financing treatment with the drug remdesivir again. This is the conclusion reached by leading medical societies.

“If costs are guaranteed, Remdesivir – which has been proven to significantly reduce severe COVID-19 courses – could be used in all clinics in accordance with the guidelines. This leads to fewer COVID-19 patients in the intensive care units and thus to more capacity for other necessary treatments,” says Professor Torsten Bauer, President of the German Society for Pulmonology and Respiratory Medicine (DGP). Together with the German Society for Internal Medicine (DGIM) and the German Society for Infectious Diseases (DGI), the DGP criticizes the fact that both statutory and private health insurance companies were relying on official channels to cover the costs of remdesivir at the end of 2021, thus leading to a tightening of the regulations situation in the clinics if the cost issue is not resolved as quickly as possible.

The costs for early treatment with remdesivir are between 2,000 and 3,000 euros - depending on the duration of therapy. Many clinics are currently stuck with these costs. Because the drug, as a new examination and treatment method, is not yet included in the flat-rate hospital billing system that applies throughout Germany, according to which patient treatment is reimbursed according to diagnosis-related case groups. For remdesivir, the clinics can only submit an application for temporary reimbursement to the health insurance companies. However, processing can take years and there is no guarantee that the funds will be approved. “The clinics cannot work with this uncertainty. Quality and cost-effectiveness must be brought into harmony, especially in Corona times,” says Torsten Bauer. In concrete terms, this would mean that if the costs for the highly effective remdesivir are not covered, more and more clinics could withdraw from regular care for COVID-19 patients for economic reasons alone.

Shortage expected: Only a third of all clinics apply for remdesivir subsidies

It can already be seen in many federal states that more and more hospitals are no longer accepting corona patients - and are thus putting even more strain on other facilities. Bottlenecks in winter are to be expected. It is currently difficult to record a specific number of hospitals: “However, it is noticeable that only around a third of all clinics have submitted an additional application for the special remuneration for Remdesivir this year. “So if you don’t have any remaining stocks of the drug, you will probably no longer use Remdesivir,” explains Bauer. A request to the DGP's Institute for the Hospital Remuneration System (InEK) shows that out of 1,903 hospitals, only 675 facilities had submitted an application for remdesivir remuneration for 2022. According to the current regulations, anyone who has not yet submitted the application must bear the costs themselves - or simply forego the use of the medication. The application deadline for overnight stay costs from health insurance companies for 2023 expires on October 31st of this year.

Predictable: Without financing, there will be a lack of treatment capacity in winter

For doctors working in clinical settings, the scenario is predictable: “If the federal government does not guarantee the financing of antiviral agents such as remdesivir as quickly as possible, fewer and fewer clinics will use them. This leads to more serious corona cases and more patients who have to be treated in hospital for significantly longer. This in turn inevitably puts a strain on the intensive care units and takes up treatment capacity for other cases of illness,” says Torsten Bauer. “And we assume that the number of severe acute respiratory infections – for example respiratory infections caused by bacteria such as pneumococci and influenza viruses – will rise again this winter,” said the pulmonologist. 

Therapy in accordance with guidelines is possible – with medication of national importance

The doctors in the clinics want to provide treatment in accordance with the guidelines to as many affected patients as possible. Early in the corona pandemic, the DGP, DGIM and DGI worked with eleven other scientific and medical societies to develop a guideline for the inpatient treatment of COVID-19 patients, which includes recommendations for the entire course of inpatient treatment for COVID-19 - from from admission and diagnosis to therapy and the further course of the disease. “This guideline-based therapy in hospitals now needs guaranteed funding for remdesivir - in the COVID-19 context, it is a drug of national importance and is already part of the treatment offering in all German hospitals this winter,” says Bauer. And he adds: “The financing of future medications for COVID-19 treatment must also be secured by the state now – for outpatient and inpatient treatment.” Bauer reminds us that when effective corona medications such as Paxlovid and Molnupiravir hospital emergency departments were not included.