Original article
The product life cycle of a medical technology innovation is subject to various decision-making processes that affect research and development, approval, reimbursement and utilization. What challenges do manufacturers and regulatory institutions face as a result of Section 137h of SGB V, with which a benefit assessment for new methods with high-risk medical devices was enshrined in law last year? Which evaluation criteria and evidence gathering approaches are appropriate for these medical devices? Experts discussed these questions in Berlin at the workshop “The value of medical devices: Deciding on approval, eligibility for reimbursement and use”, a joint event organized by Neubrandenburg University of Applied Sciences and the B. Braun Foundation.
19.09.2016
In Deutschland sind 80 Prozent der Kleinkinder gegen Meningokokken C geimpft, die bakteriellen Erreger von Hirnhautentzündungen und Blutvergiftungen. Eine neue Studie der Wissenschaftler vom Versorgungsatlas zeigt jedoch signifikante regionale Unterschiede der Impfquoten auf der Ebene der Landkreise. Schlusslicht ist Bad Tölz-Wolfratshausen in Bayern, wo laut der jüngsten Daten nur knapp 32 Prozent der Kleinkinder bis zum Ende des 2. Lebensjahres geimpft wurden. Spitzenreiter ist hingegen Dessau-Roßlau in Sachsen-Anhalt mit einer Impfquote von 93 Prozent.
19.09.2016
Univ.-Prof. Dr. Prof. h.c. Edmund A.M. Neugebauer ist nicht nur Senior-Professor für Versorgungsforschung an der Universität Witten/Herdecke und kürzlich im Amt bestätigter Vorsitzender des Deutschen Netzwerks Versorgungsforschung (DNVF), sondern seit 1. September dieses Jahres auch Dekan der Medizinischen Hochschule Brandenburg Theodor Fontane (MHB). Mit seiner Person übernimmt der erste Versorgungsforscher die Leitung einer staatlich anerkannten Universität, ein deutliches Zeichen dafür, dass – so Neugebauer – erkannt worden ist, dass „die Versorgungsforschung Nachholbedarf hat – besonders im Land Brandenburg mit seinen spezifischen, auch der Demographie geschuldeten Bedarfen“.
19.09.2016
Atypische Antipsychotika haben die medikamentöse Behandlung psychischer Erkrankungen revolutioniert. Gegenüber den konventionellen Therapieansätzen zeichnen sie sich durch eine nebenwirkungsärmere Beseitigung der Negativsymptome aus. Führt dieser Vorteil zu einer Verordnungspräferenz der atypischen Präparate, oder stellen sie vielmehr eine Behandlungsalternative zu den konventionellen Wirkstoffen dar?
19.09.2016
Seit April 2016 ist Dr. Andreas Meusch Direktor des Wissenschaftlichen Instituts für Nutzen und Effizienz im Gesundheitswesen (WINEG) sowie Beauftragter des Vorstands der Techniker Krankenkasse (TK) für strategische Fragen des Gesundheitswesens, und damit Nachfolger von Dr. Frank Verheyen, der das WINEG seit 2009 geleitet hat und nun bei der TK strategische Aufgaben der Arzneimittelversorgung im Bereich Versorgungsinnovation übernimmt. Meusch, der mit einer Arbeit über „Moral Hazard in der gesetzlichen Krankenversicherung“ promovierte, nimmt kein Blatt vor den Mund, wenn er das System Krankenkasse/Versorgungsforschung beleuchtet.
19.09.2016
Around 1.4 million people with dementia live in Germany today (around 35 million worldwide). According to forecasts, this number will double to around 3 million people by 2050 (115 million worldwide). On this basis, an increase of 40,000 new cases per year is predicted. One reason for this development is demographic change, which describes an increasingly aging population [1, see Fig. 1]. Age is the greatest risk factor for dementia because the likelihood of the disease increases sharply with age. This is z. For example, for 65-74 year olds it is only 1.7%, for 75-84 year olds it is 11% and increases exponentially to 30% for 84 year olds [2]. Overall, it can be said that the economic relevance of dementia will increase. One consequence of dementia is the patient's early need for care and the depression that is often associated with this disease. Depending on the severity of the disease and the resulting care effort, the costs are around 15,000-42,000 euros per patient per year [3]. Most patients today are still cared for at home with the help of relatives. The resulting costs are not yet factored into the above. As a result, the actual costs of caring for dementia patients are even higher. Furthermore, in the future there will be fewer and fewer younger people who can take on this care. One way to limit the predicted amount of care would be to provide appropriate, high-quality therapy. The aim of the present study was to analyze the care of dementia patients with galantamine based on our insurance data. <<
31.03.2016
Numerous medications are available to treat patients with type 2 diabetes mellitus (T2DM). Metformin and sulfonylureas have been in use for decades and can be used either as monotherapy or as part of combination therapies [12–14]. Since the mid-2000s, numerous new drugs have appeared on the market for the treatment of T2DM that cause fewer side effects than metformin and sulfonylureas: inhibitors of dipeptidyl peptidase 4 (DPP4), glucagon-like peptide 1 (GLP-1) receptor agonists and inhibitors the sodium/glucose cotransporter 2 (SGLT2). Their use in Europe was approved by the European Medicines Agency (EMA) in 2007, 2009 and 2013, respectively [15–17]. While DPP-4 inhibitors and GLP-1 stimulate the release of insulin and inhibit that of glucagon, the SGLT2 inhibitors influence the renal reabsorption of glucose [18–20]. Although these three drug classes have different mechanisms of action, they all prevent hyperglycemia and regulate HbA1c in patients with T2DM [18,19,21]. Although such drugs have already proven their effectiveness, the success of these therapies depends not only on the drugs themselves, but also on compliance [22], nutrition [23], management and treatment strategies [24,25]. The aim of this study was therefore to analyze the changes in a German T2DM population before (2006) and after (2010, 2014) the introduction of these new drugs in order to gain a better understanding of their effects.
31.03.2016
Immigration to Germany, which has increased significantly since 2014 and increased sharply since 2015, also poses new challenges for the health care system in particular when it comes to ensuring health care. The previously insufficiently researched problem of overcoming language barriers, cultural differences and logistical challenges to ensure optimal access to healthcare, but also to ensure that migrants receive healthcare that meets their needs, should be examined in this study – the first “Berlin Migrant Study” – by GeWINO be discussed and presented. The North East Health Sciences Institute (GeWINO) of the AOK Nordost has been monitoring the development of health care for people with a migrant background for some time now, also within the framework of the “International Health Insurance” focus, and, together with regional partners, is looking for quick and unbureaucratic solutions to improve the health care of migrants in Berlin, Brandenburg and Mecklenburg-Western Pomerania. The aim of the first “Berlin Migrant Study” was to provide data and facts on the current development of health care for migrants in Berlin in order to support the planning and development of regional structures to overcome the challenges posed by migration in the German health care system and to address these through innovative measures AOK Nordost to be added. The first “Berlin Migrant Study” was carried out by the North East Health Sciences Institute (GeWINO) of the AOK Nordost in cooperation with the bbw Bildungswerk der Wirtschaft in Berlin und Brandenburg eV and the bbw Hochschule Berlin in 2015. The second “Berlin Migrant Study”, which is being carried out in the same constellation, has already been started and GeWINO will continue to devote itself to the topic in the future.
31.03.2016
In Germany, an estimated 250,000 people with diabetes currently have a foot lesion and around 1 million diabetics are at increased risk of suffering a foot injury. This makes diabetic foot syndrome (DFS) one of the main complications of patients with diabetes mellitus, with the most significant consequences of diabetic foot problems being ulcers (deep substance defects, commonly ulcers - often in the form of chronic wounds) as well as small (minor) and high (major) Amputations are [1]. Although the DMP diabetes mellitus type 2 has been in existence since 2003 and the DMP diabetes mellitus type 1 since 2005, in which over four million diabetics now take part [2] and thus outpatient care for diabetics has improved overall, they appear to have increased complication rates microangiopathy, especially that of diabetic foot syndrome, does not have a positive effect. When checking the level of target achievement of the fund's own DMP Diabetes, the AOK Nordost noticed that the once-a-year foot examination specified here was not carried out without interruption for all diabetics, and that if an abnormal foot status was detected, there was not always a referral or a late referral to a specialist The treatment and further treatment of the abnormal foot was only initiated with a long delay and amputations occurred, although only low levels of severity were consistently stated in the DMP documentation. In 2011, the “Gesundheitskasse” took this as an opportunity to conclude a contract with doctors who are particularly qualified to care for DFS patients in accordance with Section 73c SGB V, which is intended to improve diabetologically qualified outpatient care for insured persons with DFS. This article presents the first evaluations of the DFS contract, with which AOK Nordost was able to meet its self-imposed goal of reducing amputations among its insured persons with diabetic foot syndrome.