Abstracts by key term: Cost
Aufgrund der demografischen Entwicklung werden Demenz-erkrankungen in ihrer Häufigkeit zunehmen (Nationale Demenzstrategie, BMFSFJ und BMG (2020)). Die häufigste Ursache einer Demenz im Alter ist die Alzheimer-Krankheit (Scheltens et al. 2021). In den letzten 20 Jahren wurde unter anderem durch die Entwicklung aussagekräftiger Biomarker im Liquor und in der Positronenemissionstomografie (PET) eine Frühdiagnostik der Alzheimer-Krankheit bereits im Stadium der leichten kognitiven Störung (Mild Cognitive Impairment, MCI) möglich (Dubois et al. 2024). Die diagnostischen Möglichkeiten werden in naher Zukunft durch blutbasierte Biomarker erweitert, die die biologische Frühdiagnostik der Erkrankung ergänzen, vereinfachen und in Teilen konventionelle Biomarker ersetzen können (Hansson et al. 2023). Auf klinisch-symptomatischer Ebene bleibt die Herausforderung, das frühe Syndrom des MCI in der Versorgungspraxis zu erkennen und zugehörige Biomarkerbefunde korrekt zu interpretieren. Gedächtnisambulanzen, die zunächst an Universitätskliniken in den 1980er- und 1990er-Jahren entwickelt wurden und inzwischen auch an Versorgungskrankenhäusern angesiedelt sind, sowie wenige spezialisierte nervenärztliche Praxen sind die Kompetenzzentren für die klinische Früh- und Differenzialdiagnostik, die Anwendung von Biomarkern sowie die Beratung und Therapie der Patienten1 (Hausner et al. 2021).
01.12.2025
The empirically based simulation model proposed here, which equally considers accessibility, patient preference, and capacity, offers, against the backdrop of the state's duty of care and the obligation to use resources economically, a scientific way of relating the importance of care to the need for hospital locations per service group. The simulation model is intended to support hospital planning (here: the allocation of service groups) by the federal states and to create guidelines for rational planning. It is also suitable for the management of financial resources within the framework of hospital reform. It enables impact analysis and does not intend to automate or otherwise impose rigid specifications. The calculations are to be viewed as examples. The weightings of all parameters are variable. However, the accessibility limits and the parameterization of the simulation model should be determined jointly by the federal and state governments in the spirit of a common target vision.
03.06.2024
The Defined Daily Dose (DDD) is a theoretical quantity that was developed as an international standard comparison quantity for drug consumption research. It indicates the assumed mean maintenance dose per day in adults for an active ingredient in its main indication. In Germany, the official German version of the ATC classification (Anatomical-Therapeutic-Chemical Classification) including the DDD information is published by the DIMDI (German Institute for Medical Documentation and Information) (DIMDI 2010). This is based on the version of the WHO, which is responsible for creating the internationally standardized ATC/DDD system (Fricke et al. 2011). Both the WHO and the AOK Scientific Institute (WIdO), which in turn publishes the methodology of the ATC classification and DDD determination for Germany, point out that the DDD is a calculated quantity that is not related to the therapeutic or prescribed dose may be confused. For longitudinal drug consumption research, the DDDs must be kept stable and are therefore unsuitable as a basis for decision-making for questions regarding drug reimbursement, pricing and therapy (Fricke et al. 2011).
02.10.2012
In recent years, the use of biotechnologically produced drugs has increased significantly. These active ingredients, which are usually produced through the use of bacteria or cell cultures, are used in a variety of indication areas. Biotechnologically produced active ingredients are used particularly in the treatment of serious diseases such as anemia in kidney disease, rheumatoid arthritis and other systemic diseases as well as various cancers (Roger 2006). One way to save costs in the area of biologicals is to increase the use of so-called “biosimilars”, which can be developed by other manufacturers and brought onto the market after the patent protection of the biological has expired. As part of a model calculation, it was examined how high these expected savings could be by substituting the reference biologicals with biosimilars using the example of selected European countries between 2007 and 2020.