Abstracts by key term: Health Economics
With the Statutory Health Insurance Competition Strengthening Act (GKV-WSG), the Institute for Quality and Efficiency in Health Care (IQWiG) has been given the additional task of carrying out the economic evaluation of medicines in the form of cost-benefit assessments. In their last article for this magazine (MVF 1/2009: 32-37), the head of IQWiG, Prof. Dr. med. Peter Sawicki and two of his employees briefly presented the methodology newly developed by IQWiG and its motivation. Against the background of many years of research in health economics, the conclusion is disappointing. Neither the internationally applied standards of scientific research were taken into account, nor were the long-standing experiences of other comparable assessment agencies such as the National Institute for Health and Clinical Excellence (NICE) taken into account in the specific design of the cost-benefit assessment. The hope remains that with the presentation and discussion of the recently commissioned pilot studies, the influence of health economics experts will increase again in order to move the German special approach in cost-benefit assessment more towards the standards accepted in health economics.
01.04.2009
In Germany, health economic instruments for drug evaluation were introduced for the first time through the GKV Modernization Act. The basis for this economic evaluation of medicines is the international standards of health economics, which are explicitly required by law. The draft methods presented by IQWiG have so far been inadequate and have been subject to widespread criticism. The efficiency frontier concept proposed by IQWiG is subject to many methodological shortcomings. In addition, the QALY is strictly rejected as a cross-indication benefit measure. The chosen perspective of the insured community and the close integration of the benefit parameters also do not correspond to the international standard. The IQWiG proposal is therefore not suitable for creating the necessary instructions for carrying out cost-benefit assessments of new medical technologies. A look at the international methods that have been established in many other countries for some time shows all the necessary solutions. This solution will also have an impact on the healthcare research landscape.
01.04.2009
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.