Arzneimittelversorgung In Der Gkv Und 15 Anderen Europ Ischen Gesundheitssystemen
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Arzneimittelversorgung In Der Gkv Und 15 Anderen Europ Ischen Gesundheitssystemen
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Author : Busse, Reinhard
language : de
Publisher: Universitätsverlag der TU Berlin
Release Date : 2015-08-06
Arzneimittelversorgung In Der Gkv Und 15 Anderen Europ Ischen Gesundheitssystemen written by Busse, Reinhard and has been published by Universitätsverlag der TU Berlin this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-08-06 with Medical categories.
Die Arzneimittelversorgung für gesetzlich Krankenversicherte und im Speziellen die Problematik der Bildung der Erstattungspreise bleibt auch nach den jüngsten gesetzlichen Änderungen in Deutschland ein zentrales Thema der gesundheitspolitischen Diskussion. Aktuell werden Erstattungsbeträge für Arzneimittel mit neuen Wirkstoffen zwischen GKV-Spitzenverband und pharmazeutischen Unternehmen im Rahmen der AMNOG-Verhandlungen vereinbart. Grundlage dieser Verhandlungen sind die Beschlüsse des Gemeinsamen Bundesausschusses über den Zusatznutzen eines neuen patentgeschützten Arzneimittels. Für Arzneimittel ohne festgestellten Zusatznutzen, die einer Festbetragsgruppe zugeordnet werden können, finden diese Verhandlungen nicht statt. Das übergreifende Ziel der Studie ist es, die Arzneimittelversorgung auf Grundlage eines systematischen Ländervergleichs anhand ausgewählter Kriterien darzustellen und ein umfassendes Bild der regulatorischen Mechanismen aufzuzeigen, welches die Arzneimittelversorgung in europäischen Ländern im Vergleich zu Deutschland prägt. Im Fokus der vergleichenden Analyse stehen hierbei Regulierungsmechanismen, welche auf die Zulassung, Postlizenzierungsevaluation, Preisbildung und -aktualisierungen, finanzielle Beteiligungen der Patienten, Maßnahmen der Wirtschaftlichkeits- oder Qualitätssicherung sowie Regulierungsmechanismen für Generika fokussieren. Des Weiteren wird untersucht, wie sich die Preise bedingt durch Regulierungsmechanismen in den Vergleichsländern unterscheiden. Die Studie basiert auf einer umfassenden Stichprobe von 16 europäischen Gesundheitssystemen (Belgien, Dänemark, Deutschland, England, Finnland, Frankreich, Griechenland, Irland, Italien, Niederlande, Österreich, Portugal, Schottland, Schweden, Spanien und Polen). Um eine grundlegende Informationsbasis für die Vergleichsländer zu beschaffen, wurden quantitative Daten von der OECD, landesspezifische regulatorische Dokumente sowie publizierte und graue Literatur herangezogen. Aufbauend auf der Systematisierung und tabellarischen Darstellung der länderspezifischen Informationen, wurden Experten im jeweiligen Land zum Review dieser Informationen herangezogen. Die Arzneimittelversorgung in der deutschen GKV weist im Vergleich zu den betrachteten europäischen Ländern auch nach den Änderungen durch das AMNOG eine sehr geringe „Verzögerung“ zwischen Marktzulassung eines neuen Arzneimittels und der tatsächlichen, öffentlich finanzierten Nutzung dieses Präparates auf. Eine Erstattungsfähigkeit besteht für praktisch alle Präparate und je Produkt für alle zugelassenen Indikationen, während Einschränkungen auf bestimmte Indikationen oder Patientengruppen in anderen Ländern häufig auftreten. Diese vergleichsweise „großzügige“ Erstattungsfähigkeit von rezeptpflichtigen Arzneimitteln – sowie die verhältnisweise mäßigen Zuzahlungen – spiegeln sich in sehr hohen öffentlich finanzierten Arzneimittelausgaben pro Kopf wider. Auch unter Einbezug der privaten Gesundheitsausgaben weist Deutschland überdurchschnittlich hohe Arzneimittelausgaben auf. Da der Anteil an Generika in Deutschland auf verhältnisweise hohem Niveau liegt, dürfte dies zum einen auf das überdurchschnittliche Preisniveau und zum anderen auf die Nutzung von neuen (und teureren) Arzneimitteln zurück zu führen sein. Insgesamt sieht sich Deutschland primär weder vor der Herausforderung einen besseren Zugang zu neuen Arzneimitteln zu gewährleisten, noch niedrigere finanzielle Hürden für Patienten einzuführen. Kosten und Qualitätsaspekte verdienen weiterhin die meiste Aufmerksamkeit. Um den „Value for Money“ zu erhöhen, könnte eine gezieltere Nutzungsteuerung bei neuen Arzneimitteln etwa durch eine Differenzierung der Erstattungsfähigkeit erwogen werden. Da die Nutzenbewertung bereits auf der Ebene von Subgruppen stattfindet, liegen die hierfür notwendigen Informationen vor und können bei der Entscheidung über die Erstattungsfähigkeit (und nicht nur über den Erstattungspreis) genutzt werden. Pharmaceutical care in the statutory health insurance system remains among the main topics in the health policy debate in Germany, not least regarding the benefit-oriented pricing and reimbursement amount negotiations introduced by the most recent changes in legislation. Prices for newly authorized pharmaceuticals are to depend on patient benefit. The Federal Joint Committee determines whether new patented pharmaceuticals have an additional benefit compared to existing alternatives and what it amounts to. Reimbursement amounts are agreed on by the manufacturers and the Federal Association of Sickness Funds (AMNOG negotiations), unless no additional benefit has been demonstrated and the pharmaceutical can be incorporated into a reference price group. The objective of this systematic country comparison was to contextualize pharmaceutical care in the statutory health insurance system in Germany by illustrating its main characteristics and underlying regulatory mechanisms in relation to other European health systems. The investigation spans measures related to marketing authorization; pricing and price updates; post-marketing evaluations guiding coverage decisions (health technology assessment); patient cost-sharing; specific cost and quality control measures targeting individual stakeholder groups (industry, wholesalers/pharmacists, prescribers); generic substitution; and resulting price levels. Including Germany, a sample of 16 European health systems was selected (Austria, Belgium, Denmark, England, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Poland, Portugal, Scotland, Spain, and Sweden). Quantitative data from the OECD, country-specific regulatory documents as well as published and grey literature were combined to form an initial evidence base in the form of health system profiles, which were then sent to relevant experts for review and validation. Compared to the other health systems in the sample, pharmaceutical care in the statutory health insurance system in Germany is characterized by a very short delay between marketing authorization of new pharmaceuticals and their statutory reimbursement (i.e. actual patient access), as well as high availability of such products. While in other health systems reimbursement restrictions based on indication or patient group are not uncommon, virtually all authorized products and all authorized indications per product are eligible for reimbursement in the German statutory system. This comparatively generous reimbursement, in conjunction with moderate copayments, is reflected in the public pharmaceutical expenditure per capita, which is among the highest in the sample. Total pharmaceutical expenditure is also relatively high, both per capita and as a share of GDP. Given that the share of generics in Germany is quite high, it is likely that above-average price levels and the utilization of new (and more expensive) pharmaceuticals contribute to this phenomenon. Thus, enabling better access to innovative pharmaceuticals and lowering financial hurdles for patients do not seem to be the main challenges for the German pharmaceutical market. However, cost and quality aspects merit continued attention. To increase value for money, a more targeted utilization control could be considered, for example by differentiating reimbursement eligibility for newly authorized pharmaceuticals. Since benefit assessments by the Federal Joint Committee already consider evidence at subgroup level, the necessary information is already available and could be used to inform decisions on reimbursement eligibility in addition to pricing.
Ensuring Value For Money In Health Care
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Author : Corinna Sorenson
language : en
Publisher: WHO Regional Office Europe
Release Date : 2008
Ensuring Value For Money In Health Care written by Corinna Sorenson and has been published by WHO Regional Office Europe this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Business & Economics categories.
This report addresses the concepts and controversy surrounding health technology assessment in Europe, with a particular focus on selected Member States including Sweden, the Netherlands, Finland, France, Germany and the United Kingdom. It is intended to identify and address current considerations regarding HTA methodological and process issues related to the prioritization and financing of modern health care. In particular, it describes the processes and challenges for identifying and prioritizing assessments; assesses and compares current assessment methods and procedures; and highlights the barriers to effective implementation. The report also ascertains the roles and terms of engagement of key stakeholders, and captures the opportunities and challenges for the use of HTA guidance in general priority-setting, decision-making and health-care provision.
Bitcoin Blockchain And Cryptoassets
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Author : Fabian Schar
language : en
Publisher: MIT Press
Release Date : 2020-09-01
Bitcoin Blockchain And Cryptoassets written by Fabian Schar and has been published by MIT Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-09-01 with Business & Economics categories.
An introduction to cryptocurrencies and blockchain technology; a guide for practitioners and students. Bitcoin and blockchain enable the ownership of virtual property without the need for a central authority. Additionally, Bitcoin and other cryptocurrencies make up an entirely new class of assets that have the potential for fundamental change in the current financial system. This book offers an introduction to cryptocurrencies and blockchain technology from the perspective of monetary economics.
Recommendation On Social Protection Floors
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Author : Tineke Dijkhoff
language : en
Publisher: Kluwer Law International B.V.
Release Date : 2016-04-24
Recommendation On Social Protection Floors written by Tineke Dijkhoff and has been published by Kluwer Law International B.V. this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-04-24 with Law categories.
Despite the international community’s recognition of social protection as a human right, the vast majority of the world’s population still has no access to social protection. In a major effort to address this situation, the International Labour Conference unanimously adopted the Social Protection Floors Recommendation 202 of 2012. However, because of the wide variety of possible schemes (and techniques that can be employed to administer them), there is a genuine risk that important values relating to social protection will be overlooked in implementing the Recommendation. This collection of expert essays contains an in-depth clarification and analysis of the Recommendation and sets forth a clear and practicable set of principles that can be used both as a policy tool and as an assessment framework for the creation, maintenance, and supervision of a national social protection floor. This book pays detailed attention to each of the Recommendation’s key principles, including the following: – state responsibility; – universality of protection; – entitlement based in law; – adequacy and predictability of benefits; – non-discrimination; – financial solidarity; – good governance; – coherence of policies; and – social participation. A special feature of the book is its inclusion of case studies that display innovative social protection schemes focusing on children and families, persons of working age (particularly informal sector workers), and elderly persons. A concluding section offers useful insights on measures that can be taken and lessons learned. As a deeply informed and practical guide to ways in which states can (and do) establish and maintain a social protection floor as a fundamental element of their national social protection systems, this book has no peers. It will be warmly welcomed by jurists concerned with social protection throughout the world, by pertinent government agencies at all levels, by non-governmental organizations, and by academics in the field.
Insurance Economics
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Author : Peter Zweifel
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-02-24
Insurance Economics written by Peter Zweifel and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-02-24 with Business & Economics categories.
Presenting theoretical foundations and empirical research, this text introduces the reader to the core issues and analytical tools of insurance economics, examining in detail a host of key factors including supply and demand, regulation and social insurance.
Health At A Glance Europe 2016 State Of Health In The Eu Cycle
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Author : OECD
language : en
Publisher: OECD Publishing
Release Date : 2016-11-23
Health At A Glance Europe 2016 State Of Health In The Eu Cycle written by OECD and has been published by OECD Publishing this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-11-23 with categories.
This fourth edition of Health at a Glance: Europe presents key indicators of health and health systems in the 28 EU countries, 5 candidate countries to the EU and 3 EFTA countries.
Health Economics
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Author : Peter Zweifel
language : en
Publisher: Springer Science & Business Media
Release Date : 2009-07-14
Health Economics written by Peter Zweifel and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2009-07-14 with Business & Economics categories.
This is the most complete text available on the economics of health behavior and health care delivery. Appropriate both for advanced undergraduate and beginning graduate students of economics, this text provides the key analytical tools required to understand current research. Issues discussed include the "cost explosion" in health care, the power of medical associations, the search for remuneration systems with favorable incentives, and technological change in medicine. Rather than simplifying the issues facing today’s healthcare systems, the book models existing complexities as they are, adapting economics to reflect the views of the average person.
Service Business Model Innovation In Healthcare And Hospital Management
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Author : Mario A. Pfannstiel
language : en
Publisher: Springer
Release Date : 2016-12-16
Service Business Model Innovation In Healthcare And Hospital Management written by Mario A. Pfannstiel and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-12-16 with Medical categories.
This book demonstrates how to successfully manage and lead healthcare institutions by employing the logic of business model innovation to gain competitive advantages. Since clerk-like routines in professional organizations tend to overlook patient and service-centered healthcare solutions, it challenges the view that competition and collaboration in the healthcare sector should not only incorporate single-end services, therapies or diagnosis related groups. Moreover, the authors focus on holistic business models, which place greater emphasis on customer needs and put customers and patients first. The holistic business models approach addresses topics such as business operations, competitiveness, strategic business objectives, opportunities and threats, critical success factors and key performance indicators.The contributions cover various aspects of service business innovation such as reconfiguring the hospital business model in healthcare delivery, essential characteristics of service business model innovation in healthcare, guided business modeling and analysis for business professionals, patient-driven service delivery models in healthcare, and continuous and co-creative business model creation. All of the contributions introduce business models and strategies, process innovations, and toolkits that can be applied at the managerial level, ensuring the book will be of interest to healthcare professionals, hospital managers and consultants, as well as scholars, whose focus is on improving value-generating and competitive business architectures in the healthcare sector.
The Oxford Textbook Of Clinical Research Ethics
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Author : Ezekiel J. Emanuel
language : en
Publisher: Oxford University Press
Release Date : 2008-05
The Oxford Textbook Of Clinical Research Ethics written by Ezekiel J. Emanuel and has been published by Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-05 with Medical categories.
The Oxford Textbook of Clinical Research Ethics is the first systematic and comprehensive reference on clinical research ethics. Under the editorship of experts from the National Institutes of Health of the United States, the book offers a wide-ranging and systematic examination of all aspects of research with human beings. Considering historical triumphs of research as well as tragedies, the textbook provides a framework for analysing the ethical aspects of research studies with human beings. Through both conceptual analysis and systematic reviews of empirical data, the textbook examines issues ranging from scientific validity, fair subject selection, risk benefit ratio, independent review, and informed consent as well as focused consideration of international research ethics, conflicts of interests and other aspects of responsible conduct of research. The editors of The Oxford Textbook of Clinical Research Ethics offer a work that critically assesses and advances scholarship in the field of human subjects research with human beings.
The Social Construction Of Illness
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Author : Jens Lachmund
language : en
Publisher:
Release Date : 1992
The Social Construction Of Illness written by Jens Lachmund and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1992 with Medical categories.