Abstracts by key term: GKV
Adipositas und ihre Folgeerkrankungen zählen weltweit zu den bedeutendsten Herausforderungen für die öffentliche Gesundheit. Mit der steigenden Verbreitung von Adipositas nehmen auch kardiometabolische Erkrankungen (z. B. Typ-2-Diabetes mellitus, arterielle Hypertonie, koronare Herzkrankheit und Herzinsuffizienz), bestimmte Tumorerkrankungen und Muskel-Skelett-Erkrankungen zu. Bei Erwachsenen in Deutschland zählt ein höherer Body-Mass-Index (BMI) zu den größten Risikofaktoren im Hinblick auf die […]
05.10.2026
With around six million diagnosed patients, diabetes mellitus is one of the most common chronic diseases in Germany. In addition, the number of diabetics is increasing - regardless of population aging (RKI 2011). In addition, diabetes is one of the most costly diseases. In statutory health insurance (GKV), a diabetic incurs about twice as high direct treatment costs as a non-diabetic insured person (Köster et al. 2006). Almost 30 percent of all diabetics are treated with insulin (Hauner 2007); These include all type 1 diabetics and those type 2 diabetics for whom the body's own insulin production is no longer sufficient despite lifestyle changes and treatment with oral antidiabetics. When it comes to insulin, a distinction can be made between mixed insulins, short-acting, so-called bolus insulins, and long-acting, so-called basal insulins. The latter include NPH insulin (Neutral Protamine Hagedorn), insulin glargine and insulin detemir. Basal insulin accounts for around 30 percent of the total daily insulin doses prescribed on an outpatient basis and 34 percent of statutory health insurance expenditure on insulin (Mengel 2010; INSIGHT Health 2011). The aim of the study presented here is to compare the costs of three treatment strategies that differ in terms of the basal insulin used. Only diabetics who received at least two prescriptions of either insulin glargine or insulin detemir or NPH insulin at the expense of the statutory health insurance in 2010 are included. The outpatient diabetes-related prescriptions for bolus insulins, antidiabetics, blood sugar test strips, needles and lancets billed via pharmacy computing centers are also taken into account. The prescriptions are valued at pharmacy sales prices (Lauer tax) less the statutory manufacturer discounts in accordance with Section 130a Paragraphs 1, 1a, 3b SGB V.
02.10.2012
Since 2003, health insurance companies have been able to conclude individual discount agreements with pharmaceutical manufacturers. Due to a change in the legal situation, since the beginning of 2009, drug discount contracts in the form of active ingredient contracts have had to be advertised across Europe if the turnover covered by this exceeds 193,000 euros. The change from freely negotiated so-called portfolio contracts to tenders has led to various problems in the reality of supply. This article examines the topic from different perspectives and provides information on how, with the involvement of all those involved, discount agreements can be integrated smoothly into the (standard) supply landscape.
17.10.2010
The instrument of drug discount contracts was implemented in the statutory health insurance (GKV) system in order to curb drug spending in the outpatient sector. The GKV Competition Strengthening Act (GKV-WSG), which came into force on April 1, 2007, paved the way for health insurance companies to be able to conclude discount agreements with pharmaceutical manufacturers more effectively than before. Since then, pharmacists have had to give preference to discounted medications. Ideally, both manufacturers and health insurance companies can benefit from such discount agreements.
01.06.2010
The idea behind the introduction of individual contractual elements such as drug discount agreements into the statutory health insurance system is to initiate quality and performance competition between the health insurance companies. The necessary basic prerequisite for this competition to function is performance differentiation and the perception of these differences by the consumer. Only then can the insured represent a demand-side corrective for the competitive result through their health insurance choices. The answers to a current population survey by the Allensbach Institute for Demoscopy show that these requirements are not met and that expectations with regard to the quality of the services offered and the quality of care are hardly justified. The prospects of eliminating existing information deficits on the consumer side through targeted communication strategies must be assessed differently for the different supply areas.