Original article
IQWiG worked for almost two years together with national and international experts on a method for assessing cost-benefit ratios. An essential part of this method is the analysis of the efficiency frontier, which - according to the then director of the institute, Prof. Dr. Peter T. Sawicki - “the method most suitable for the German framework conditions”. But this was exactly what met with harsh criticism when the method paper was presented in October 2009: 29 leading German health economists rejected the IQWiG proposal as “scientifically untenable” and “not normatively justified”. “Nowhere in the method paper is an algorithm described how a sum parameter is calculated through which the weighting of benefits and harms is carried out,” criticized Prof. Dr. med. Jürgen Fritze, senior association doctor at the PKV Association. The institute addressed this shortcoming with two general contracts in the form of pilot studies, with a “Conjoint Analysis” (CA) in the indication Hepatitis C and an “Analytic Hierarchy Process” (AHP) in the indication Major Depression - unfortunately in two different indication areas, so that a direct comparison is not possible. The goal, which now seems within reach: to scientifically describe procedures that make it possible to describe a cardinal benefit value, with the help of which all conceivable therapy alternatives in an indication area can be compared across all relevant endpoints. With the head of the “Conjoint Analysis” pilot study, Prof. Dr. Axel Mühlbacher (Neubrandenburg University, IGM Institute of Health Economics and Medical Management and co-founder of the Society for Empirical Consulting mbH), spoke about “Monitor Health Services Research”.
24.02.2012
Der Bonner Jurist Josef Hecken war bis auf einen kleinen Ausflug in die Privatwirtschaft - 1998/1999 war er Abteilungsleiter bei der METRO AG-Konzernholding - Zeit seines Lebens in Ministerien tätig. Von sich reden machte er als Minister für Justiz, Gesundheit und Soziales des Saarlands, als er 2006 die ersten DocMorris-Filialen zuließ und von 2004 bis 2008 Vorsitzender des Gesundheitsausschusses war. Von 2008 bis 2009 war er als Präsident des Bundesversicherungsamtes unter anderem für die Einführung des Gesundheitsfonds und des Morbi-RSA zuständig, seit Dezember 2009 dann als Staatssekretär im Bundesministerium für Familie, Senioren, Frauen und Jugend u.a. für die Einführung des Betreuungsgeldes. Zum 1. Juli 2012 übernahm Hecken das Amt des unparteiischen Vorsitzenden des Gemeinsamen Bundesausschusses (G-BA).
24.02.2012
Diabetic foot syndrome is a secondary disease of diabetes mellitus and often leads to non-traumatic amputations. These are associated with high medical costs, loss of quality of life and high mortality (Heller et al. 2004). Diabetic foot syndrome occurs with a prevalence of 6.5% among type 2 diabetes patients (Lauterbach et al. 2010). Endogenous risk factors such as B. diabetic polyneuropathy or peripheral arterial disease (PAD) have a prevalence of 30% and 25%, respectively (Lauterbach et al. 2010). Prevention of diabetic foot syndrome is therefore very important. In addition to the endogenous risk factors mentioned, exogenous factors such as: For example, inadequate footwear or poor foot care play a crucial role (Uccioli et al. 1995; Chantelau/Haage 1994; Brent et al. 2006). According to the International Consensus on the Diabetic Foot (1999), the prevalence of diabetic foot syndrome could be reduced through, among other things, regular inspections of the feet and footwear, training of patients and family members and the wearing of suitable footwear. An important and effective intervention measure is to train and instruct patients to self-inspect their feet.
24.02.2012
For years, numerous national and international publications have confirmed that in Germany, by international comparison, too few medically necessary operations are performed on an outpatient basis (Brökelmann 2007: 5; Toftgaard/Parmentier 2006: 42-48). Although it is known that some of these deviations can also be explained by different organizational and financial factors in the respective countries, the deviations in some operations are still too clear for these explanations to be used as the sole justification for the differences (Busse/Wörtz 2009: 52 – 54; Oberender & Partner 2010: 26 – 28).
24.02.2012
Health services research is a multidisciplinary scientific discipline with a comparatively young history [1]. The desired goals of this scientific discipline are of great importance for assessing the situation in the healthcare system - possibly with corresponding effects on practice, politics and science. According to Pfaff [2], health services research can be defined as an “interdisciplinary research area that describes and causally explains health care and health care and its framework conditions, as well as evaluates the effectiveness of care structures and processes under everyday conditions”. Particular emphasis should be placed on the analysis of medical questions or issues relating to healthcare in general under everyday conditions, which therefore differs significantly from the classic clinical study. In particular, the field of health services research is divided into different areas that arise from the subject matter of the study (e.g. needs research, quality research, health care epidemiology).
24.02.2012
A significant increase in chronic diseases, massively increasing costs with uncertain financing, a lack of coordination with inadequate or incorrect care, and a lack of quality with the wrong incentive system are major challenges for the actors involved and the politics of the American healthcare system. To counteract this trend, President Obama passed the Patient Protection and Affordable Care Act (PPACA) as part of his healthcare reform. It represents the legal basis for a performance and results-oriented realignment, one of the elements of which is the establishment of accountable care organizations (ACOs). (See MVF 06/11 “Accountable Care Organizations (ACOs) as an innovation in the American healthcare system”).
24.02.2012
The “Integrated Care for Healthy Kinzigtal”, which was launched in 2005, is definitely a flagship project of a different, more modern care concept. A whole series of evaluations of individual intervention programs as well as the results for all insured persons of the participating health insurance companies show that, on the one hand, hospital admissions and the number of prescriptions for unnecessary medication are decreasing, and on the other hand, the contribution margin, for example for the residents of the nursing homes in Kinzigtal, for whom a special care program was started , was already significantly positive in 2010, whereas in 2007 it was almost minus 3,000 euros. “The current results show how quickly integrated care can lead to substantial success, to the benefit of both the insured and the health insurance companies,” emphasizes Helmut Hildebrandt, board member of OptiMedis AG and managing director of Gesundes Kinzigtal GmbH. Hildebrandt sheds light on the success factors of the model he initiated in an interview with “Monitor Healthcare Research”.
24.02.2012
From 2002 to 2005, Birgit Fischer was Minister for Health, Social Affairs, Women and Family in the state of North Rhine-Westphalia, deputy since 2007 and then chairwoman of the board of the Barmer GEK from 2010. Until she took a big step into the industrial side in May 2011 and became CEO of the Association of Research-Based Drug Manufacturers (vfa) as the successor to Cornelia Yzer. This step was polarizing and there was even talk of it being disreputable, probably also because she was seen as a critic of the pharmaceutical industry on the health insurance side. Today, exactly one year later, such criticisms are a thing of the past, also because the trained educator sees herself as a “bridge builder”, as someone who knows and understands the different sides of the health system and is working on a new, common and, above all, sustainable care solution want.
24.02.2012
In der politischen Diskussion um die Zukunft unserer sozialen Sicherungssysteme und besonders unseres Gesundheitssystems ist der Zusammenhang zwischen Demenz und demographischem Wandel unübersehbar. Demographische Veränderungen bewirken einen steilen Anstieg der Anzahl der über 65-Jährigen bei gleichzeitigem Rückgang der Bevölkerung im erwerbsfähigen Alter. Mit dieser Entwicklung steigt auch das Vorkommen altersbedingter Erkrankungen. Dazu gehört z.B. die Demenz, für die das Alter als Hauptrisikofaktor genannt wird. Demenz-erkrankungen stellen daher eine große Herausforderung für die zukünftige gesellschaftliche Entwicklung dar: Betrachtet man aktuelle Erkrankungszahlen, so werden die Brisanz und die Wichtigkeit des Themas deutlich. Für Deutschland wird sich die Anzahl Demenzerkrankter von derzeit über 1,2 Millionen auf 2,5 Millionen im Jahre 2060 mehr als verdoppeln. Dabei ist zu bedenken, dass die Demenz einen erheblichen Aufwand an medizinischer und pflegerischer Betreuung verursacht. Sie wird daher als vermutlich teuerste Erkrankung des höheren Lebensalters bezeichnet. Der World-Alzheimer-Report (2011) spricht aufgrund dieser Entwicklungen von Demenzerkrankungen als der wesentlichen sozialen, gesundheitlichen und ökonomischen Herausforderung des 21. Jahrhunderts, der nur mit einem weiteren Ausbau von Forschung und Versorgungsstrukturen begegnet werden kann.
24.02.2012
In recent years, the use of biotechnologically produced drugs has increased significantly. These active ingredients, which are usually produced through the use of bacteria or cell cultures, are used in a variety of indication areas. Biotechnologically produced active ingredients are used particularly in the treatment of serious diseases such as anemia in kidney disease, rheumatoid arthritis and other systemic diseases as well as various cancers (Roger 2006). One way to save costs in the area of biologicals is to increase the use of so-called “biosimilars”, which can be developed by other manufacturers and brought onto the market after the patent protection of the biological has expired. As part of a model calculation, it was examined how high these expected savings could be by substituting the reference biologicals with biosimilars using the example of selected European countries between 2007 and 2020.