Original article
To date, there are only a few studies in Germany that examine the reality of iron deficiency/anemia treatment for tumor patients who are undergoing chemotherapy. As part of a European prospective observational study, a prevalence of anemia of 40% (at the start of the study) and 67% (during the course of the study) was measured in over 15,000 tumor patients in 2001/02. In addition, the proportion of patients with anemia therapy and the distribution of the different therapy options were recorded. Of these patients, almost 40% were treated with antianemic preparations, with ESA having the highest proportion among the treatment options (Ludwig et al. 2004). In addition, Steinmetz and colleagues (2016) collected data from almost 1,000 cancer patients in Germany regarding demographic and disease-specific characteristics as well as the distribution of antianemic treatment options. It was found that the majority of patients received blood transfusions to treat the anemia and that both ESA and IV iron played a rather minor role in the treatment. The aim of this cohort study is therefore to investigate the care situation of patients with tumor disease and iron deficiency/anemia therapy. In order to better understand the reality of care in Bavaria (1/7 of those insured by statutory health insurance (GKV) in Germany), patient characteristics and disease-specific therapy options were analyzed using diagnostic and billing data as part of a PHARAO project run by the Bavarian Association of Statutory Health Insurance Physicians (KVB). analyzed.
04.04.2019
It is estimated that around 200,000 people in Germany consume illegal opioid-containing substances each year (Wittchen et al. 2011). This consumption can lead to opioid dependence, a lifelong chronic disease (Wittchen et al. 2011) that is associated with psychiatric and somatic comorbidities such as hepatitis C and HIV. Even if fully synthetic opioids such as the narcotic (BTM) painkillers oxycodone or fentanyl also pose increasing problems with regard to the development of addictive behavior, heroin remains the largest problem area of opioid addiction. Heroin is also considered to be the drug with the highest addictive potential and the highest mortality (Gable 2006). The treatment of opioid addiction usually involves various substitution therapies, in which the illegal opioids are replaced by medically dispensing medication prescribed in accordance with the law and guidelines. With inadequate treatment, which without substitution therapy consists only of detoxification measures, keeping away from the substance, for example in the course of the prison system and rare consultations, the affected patients develop a “revolving door syndrome”, i.e. frequent and regular admissions to hospital, and often die of an overdose. induced respiratory paralysis or secondary comorbidities with severe malnutrition. Substitution therapy enables the decriminalization and stabilization of the patient's psychosocial situation, the systematic treatment of infectious diseases, as well as the influence on the general conditions and targeted long-term therapeutic work on comorbidities such as personality disorders and depression backgrounds. In 2017, there were 78,800 opioid-dependent patients in substitution therapy in Germany (Report on the Substitution Register 2018).
04.04.2019
Depression is one of the most frequently diagnosed mental illnesses both among the general population in Germany and among those insured by AOK Nordost. Previous studies estimate the prevalence of depression in Germany at 8.1% to 10.2%, depending on the respective study design and the underlying data source (Busch et al. 2013; Erhart and von Stillfried 2012). A continuous increase in the prevalence of depression has been observed for years (Thom et al. 2017). Even though treatment rates are constantly increasing, it is estimated that between 35% and 80% of all patients with mental disorders do not receive treatment (Larisch et al. 2013). It can be assumed that this also applies to the treatment of depression to a similar extent. In addition to individual factors as well as social and natural factors, the treatment rate also depends on the availability of service providers (Rommel et al. 2017; Helbich et al. 2018). Accordingly, the current needs planning of psychotherapists is also the subject of controversial discussion (IGES 2016; Peikert et al. 2011).
04.04.2019
The effects of certain factors evaluated in the benefit assessment process on price negotiations have been examined in other studies (Theidel & Graf von derschulenburg, 2016). The biggest influencing factor in price negotiations is the additional benefit. In this respect, G-BA decisions are stricter than the decisions of other countries regarding the same drugs and indications (Fischer, Heisser, & Stargardt, 2016). A measurement system was proposed to predict G-BA decisions regarding the additional benefit of medicines (Schwandera, Banz, Kaier, & Walzer, 2014). Since clinical data serve as the basis for deciding on the added value of drugs in benefit dossiers, this study focuses on the second important factor that can influence price negotiations: the number of patients in the target populations with a therapeutically significant additional benefit. Particularly in cases where there are multiple patient subgroups and the negotiations are based on a mixed price model, the influence of the submitted patient populations per target group is more pronounced.
04.04.2019
Lung cancer is one of the most common tumor diseases and the most common cause of cancer death in Germany.1,2 Only about 1/3 of non-small cell lung carcinomas (NSCLC), which is present in 80% of all lung cancer cases, is operable when initially diagnosed.3 For patients with advanced or In NSCLC that cannot be treated curatively, only marginal improvements in response and survival have been achieved over decades with systemic therapy, usually with chemotherapy. With the discovery that the growth of some tumors is driven by an activating mutation of the tyrosine kinase and that these can be specifically inhibited, there have been significant advances in the treatment of lung cancer in the field of precision medicine, also known as personalized medicine, for around ten years .4 This means that around 30% of all NSCLC patients in advanced stages can now be treated in a personalized or targeted manner.4 In randomized studies, patients with NSCLC and mutations in the EGF receptors have higher response rates, longer progression-free survival and lower rates when treated with a TKI Side effects compared to cytotoxic chemotherapy.8 In addition, several treatment cohorts worldwide have shown an improvement in overall survival with personalized medicine for lung cancer.9 The patients recorded in the Cologne Network for Genomic Medicine (NGM) showed lung cancer compared to a historical control group with the relevant driver mutations a significant increase in overall survival of a median of 21.9 months in EGFR-positive and 12 months in ALK-positive NSCLC patients.10
04.04.2019
Spastic movement disorder (SB) occurs as a result of damage to the central nervous system. Accordingly, SB is a symptom of numerous underlying diseases, including stroke, multiple sclerosis and infantile cerebral palsy [1, 2]. A current extrapolation from data from the Leipzig forums suggests that around 530,000 patients are affected by SB that requires treatment. A lack of care or inadequate care can have a significant impact on the quality of life of those affected. In addition to sometimes severe impairments in everyday life, contractures, ulcerations and pain can occur as accompanying illnesses. This often results in a higher need for care or a higher level of care classification [2, 3]. SB cannot be cured, but its severity and comorbidities can be reduced. Suitable therapeutic procedures are described in the specialist literature and the corresponding guidelines [4-8]. However, it can be assumed that the reality of care in Germany shows a different picture. A survey should therefore clarify what the treatment of those affected is like [9]. A total of 109 general practitioners from Germany were surveyed by post about their patient clientele with SB and their care. Since the treatment decision of the respective doctor should not be interfered with, a non-interventional, retrospective study design was chosen. The questionnaire sent out included a total of 26 questions on general information about the patient clientele, non-invasive and drug therapy and collaboration with other specialist disciplines. On average, each GP provides care to approximately 24 patients with SB.
04.04.2019
The body's native and adaptive immune system plays an important role in a variety of diseases such as psoriasis (PSO) [1], inflammatory bowel disease (CD/CU) [2] and rheumatoid arthritis (RA) [3]. These autoimmune diseases result from disruption of pro-inflammatory and anti-inflammatory responses, leading to an immune-mediated attack on the host tissue [4]. Recent decades have seen an increase in the incidence and prevalence of autoimmune diseases, highlighting the importance of appropriate treatment of these diseases [5]. Biologic drugs are treatments aimed at altering the course of autoimmune diseases and represent an important alternative to conventional treatments [6]. The main targets of biological drugs are cytokines (e.g. tumor necrosis factor-α [TNF-α], interleukin-1 [IL-1] or -6 [IL-6]), B cells and costimulation molecules (e.g. T- Cell surface protein CD28 or cytotoxic T lymphocyte-associated antigen-4 [CTLA-4]) [7]. Biological medicines have several advantages such as: B. an established long-term effect, a high selectivity for target molecules, positive cardiovascular effects, their suitability for patients with impaired kidney or liver function and maximum adherence to intake [8].
04.04.2019
In the first part of the article, under the title “Connection between digitalization and health care research,” we discussed the requirements that must exist in order to be able to depict everyday care in the health system (1). Metaphorically speaking, the function of a digital information highway and that of health services research are similar: functional highways are worthless if the exits are geographically poorly laid out and the vehicles used are only partially suitable for driving or transporting. An information highway is a necessary, but not sufficient, condition for improving healthcare. It is suitable for improving healthcare if it contributes to improving the health of citizens, rather than just a surrogate parameter, such as compliance with medical prescriptions. And health services research only has a future if it manages to prove its benefit to society. To do this, it needs instruments that are actually able to observe and measure effects under everyday conditions, i.e. it needs a three-dimensional standard for describing complex health services.
04.04.2019
The Chronic Care Congress, organized by MedEcon Ruhr, will take place in Bochum from June 12th to 13th, 2019. MedEcon Ruhr is the central hub for the healthcare industry in Germany's largest metropolitan area, comprising over 160 institutions from the hospital and healthcare sectors. The congress aims to raise public awareness of chronic care and identify areas where political reform is needed. Furthermore, the exchange between professionals, patient advocacy groups, researchers, and the healthcare industry is intended to stimulate initiatives and models, particularly within the region.
01.04.2019
Hagen Pfundner is a pharmacist, industrial manager, board member of the Federation of German Industries (BDI) and the Association of Research-Based Drug Manufacturers (VFA) and honorary professor at the University of Freiburg im Breisgau. Having worked in the pharmaceutical industry for over a quarter of a century, he is expressly committed to a technology offensive that ranges from molecular diagnostics to “red biotechnology” and genetic engineering to networked, digitized and therefore personalized medicine. This requires, he says in the title interview with “Monitor Healthcare Research”, “a common strategy, a collaborative approach by all those involved in the healthcare system, which takes social benefits into account beyond particular interests”.