Cancer management and reimbursement aspects in Germany: an overview demonstrated by the case of colorectal cancer

Abstract

This paper provides an overview of cancer management, particularly with respect to colorectal cancer (CRC), in Germany. The information presented reflects findings from the peer-review literature and government documentation, as well as interviews with cancer and CRC specialists. Topics such as epidemiology, expenditure, CRC screening, pharmaceutical and non-pharmaceutical treatment are discussed in this paper. Furthermore, insights into the German reimbursement system with regard to cancer management as well as regulatory aspects are presented.

S3-Leitlinie – Kolorektales Karzinom

“…Häufig stehen die Patienten einer Situation von untereinander konkurrierenden und unverbundenen Gesundheitsanbietern gegenüber. "Access" und "Support" sind besonders eingeschränkt in strukturschwachen ländlichen Regionen mit niedrigem Versorgungsstand [1291,1292]. In Studien wurde der Vorteil eines fallbezogenen Managements (Case-Management) durch begleitende professionelle Steuerung des Behandlungs-und Nachversorgungsverlaufs für den Patienten belegt [1293].…”

The dynamics of colorectal cancer management in 17 countries

“…All but four countries (Greece [29], Mexico [30], Russia [31] and Turkey [32]) participate in some form of CRC screening; however, only four European countries have organised formal screening (Finland, France [33], Italy [34], UK [35]), together with Australia, and only six have screening guidelines (Finland, France, Germany [36], Italy, UK, and Australia; Table 2). The FOBT is the most frequently used test [29][30][31][32][33][34][35][36][37][38][39][40][41][42], usually mailed or collected from the GP, while FS and COL are used less frequently (Germany, Italy, Poland [37], Portugal [38], the Netherlands [39]; all opportunistic or pilot) and occurring at outpatient clinics.…”

“…The FOBT is the most frequently used test [29][30][31][32][33][34][35][36][37][38][39][40][41][42], usually mailed or collected from the GP, while FS and COL are used less frequently (Germany, Italy, Poland [37], Portugal [38], the Netherlands [39]; all opportunistic or pilot) and occurring at outpatient clinics. Furthermore, all countries have different start and stop ages, ranging from starting at 50-60 and stopping at 69-74 years, as well as different testing intervals.…”

Alianza para la Prevención del Cáncer de Colon en España: un compromiso cívico con la sociedad

“…A partir de 1990 se preconiza el cribado oportunista con SOH con reembolso económico, hasta el año 2002 en que inicia el programa de cribado del CCR mediante colonoscopia. Entre los años 2003-2007 se han realizado más de 2,8 millones de exploraciones, cuyo coste asumen las instituciones sanitarias y las compañías de seguro 238,239 . Polonia comienza en 2005 un programa de detección precoz de CCR mediante colonoscopia en todo el país 240 .…”