Abstracts by keywords: Health Economics
Ausgaben für pharmazeutische Innovationen werden weitgehend als Kosten gesehen – und das umso mehr, je größer die Finanzprobleme in der GKV sind. So werden auch im ersten Bericht der Finanzkommission Gesundheit vom 30. März 2026 Arzneimittel als Kostentreiber gesehen.1 Auch der Kabinettsentwurf für ein GKV-Beitragssatzstabilisierungsgesetz (BStabG) verfällt in alte Muster und sieht deutliche Einsparungen bei […]
03.08.2026
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
Postpartum hemorrhage (PPH), defined as blood loss ≥500 ml within 24 hours of birth, is one of the most common causes of maternal mortality worldwide. In Germany, PPH occurred in 7.8% of the 693,000 births in 2023. In addition to medical therapy and uterine (balloon) tamponade, a vacuum-induced uterine compression (VUC) procedure has been available since 2024, enabling rapid hemostasis. Innovations such as VUC and the associated costs are initially not reflected in the DRG flat-rate fees in the inpatient sector, which is why additional fees are necessary for refinancing. At the same time, the product costs can be offset by resource-saving effects (including shorter lengths of stay, reduction in surgical procedures). To demonstrate these effects and evaluate them in monetary terms, a model was conducted: A resource saving in the DRG system leads to a downgrade of the DRG. Thus, a one-level reduction in the most common DRG results in a cost reduction of €983.24. The recent establishment of a specific procedure code for VUT will enable real-world analyses based on billing data in the future, as well as the long-term adjustment of case rates.
04.08.2025
The spread of invasive fungal infections poses major challenges, particularly for hospitals, due to the complexity of treatment and the associated long hospital stays. Innovative drug therapies offer potential for cross-sectoral patient care and optimized management throughout the patient journey.
02.02.2025
This article examines the practical implementation of the interface between the price regulation instruments AMNOG and the fixed price in the German pharmaceutical market from 2011 to July 2024. It examines three typical case scenarios of the linking of the price regulation instruments and analyzes the procedural practices of self-administration based on previous application.
03.12.2024
The aim of the study is to precisely examine the population-normalized treatment costs of orphan drugs. For this purpose, a study examining the treatment costs of orphan drugs for the years 2005 to 2021 was already conducted in 2022. The calculations have now been validated as part of a study update using the identical population. The update enabled inflation adjustment based on the 2022 price index as well as seamless treatment costs after AMNOG assessment and price negotiations for all orphan drugs. The analysis shows that AMNOG fulfills its function as a price regulation instrument for orphan drugs as well. Since the introduction of AMNOG, the inflation-adjusted normalized treatment costs for orphan drugs have decreased both in terms of the introductory price (minus 25% of the total) and the reimbursement amount (minus 6% of the total).
03.06.2024
The abolition of the supplementary federal subsidy in 2023, which will provide an additional 14 billion euros in the coffers of statutory health insurance (GKV) in 2022 (Bundestag 2021), thus increasing the total amount to 28.5 billion euros, gave rise to a debate about the impending funding gap for statutory health insurance in 2023. The question therefore arises as to which measures are suitable to enable targeted expenditure control in the statutory health insurance. The federal government's draft law for the financial stabilization of statutory health insurance (Federal Ministry of Health 2022) lists a number of measures that are intended to realize efficiency reserves without benefit cuts amounting to around 3 billion euros for 2023. For example, the sales threshold for drugs to treat a rare disease (orphan drugs) for the benefit assessment is to be reduced to 20 million euros.
21.09.2022
Screening for atrial fibrillation (AF) is recommended in the guidelines of the European Society of Cardiology (ESC) (Hindricks et al. 2020), but is currently not implemented in the form of systematic health programs in Germany. Given demographic changes and the age-dependent occurrence of AF, it is predicted that by 2060 the number of patients aged over 65 years with AF in Europe will increase to over 14 million (Krijthe et al. 2013). Since AF is a relevant risk factor for stroke, screening for AF will become increasingly important. In order to be able to assess the possible effects of introducing guideline-based screening for AF in the German health care context - in particular to avoid long-term health and health economic consequences - a systematic literature search was carried out in 2019. No evidence could be identified from completed, prospective studies in the German health care context that report long-term clinically relevant events after screening for AF. Against this background, a Markov model was developed with which the effects of a screening for AF can be simulated. This model is intended to contribute to the professional public discussion on the detection of AF and the prevention of thromboembolic events and to enable the derivation of adequate measures for better care. For this work, on the one hand, the long-term effects of consistent implementation of the screening measures provided for in the ESC guidelines with regard to the prevention of AF-associated strokes and systemic embolism were examined. On the other hand, the direct health economic implications were considered from the perspective of statutory health insurance (SHI).
29.01.2022
The fact that it is still not known how many people die at home in Germany is chosen as the starting point for the argument in favor of establishing a place of death register. For this purpose, the fundamental importance - with quite heterogeneous objectives and functional purpose - of medical registers is made recognizable. It becomes clear that a register of places of death can be expected to be of great benefit in the short term, particularly for health care planning and health policy, but also in the medium term for the development of the quality of care and for findings for health care research and epidemiological studies in the medium to long term. This applies to all places (milieus, settings) of care. In order to design such a place of death register effectively in terms of content and function, an interdisciplinary working group with transsectoral experience extending beyond palliative care should be brought together. However, the precise - and annually reported - determination of the place of death would be a clear and practically easy to achieve progress.
04.04.2019
More than 700,000 people already live in nursing homes; The use of inpatient care continues to increase. The few surveys about medical care in inpatient care facilities show a consistent picture. Due to the limited mobility of the residents, specialist medical care is very unsatisfactory; As a result, there are deficits in diagnostics and therapy. This is particularly true for people with dementia. In nursing homes, the rate of people suffering from dementia is around 65 %. Nevertheless, only a minority receive neurological/psychiatric care. The supply of anti-dementia drugs is inadequate. The low level of medical performance has several causes and does not correspond to society's aging image; It is also questionable from a health economic point of view. Several surveys and studies show, for example, the reduced care and nursing costs with simultaneous therapy with anti-dementia drugs (“Memantine”).