Abstracts by key term: cost-benefit assessment
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
With the most recent health care reform (GKV-WSG), the tasks of the Institute for Quality and Efficiency in Health Care (IQWiG) were expanded: Previously, it could only evaluate drugs with regard to their medical benefits. In the future, the institute should also put the costs of the medication in relation to the previously determined benefits. According to the law, these cost-benefit assessments are intended, on the one hand, to set maximum amounts for certain medications. On the other hand, they can support the Federal Joint Committee (G-BA) in assessing the cost-effectiveness of medical procedures. The proposed concept favors “efficient frontier analysis” as a method. The second element is a “budget impact analysis” to estimate how decisions affect healthcare spending.
01.03.2009
It is currently becoming apparent that the discount agreements are reinforcing a development that leads to market results that do not do justice to the relative or absolute value of the medicines and thus lead to allocative inefficiencies. Against this background, a proposal for a central approach to controlling the generic drug market, based on a cost-benefit assessment, was developed. The core of the model is that the reimbursement prices in the statutory health insurance are set in such a way that they reflect the benefit ratio of the drugs to each other. In this way, the approach induces a needs-oriented and efficient distribution of scarce resources in drug supply. The approach also offers a pragmatic multi-step scenario with budget neutrality in the introduction phase of the model.