Principal‐agent theory‐based cost and reimbursement structures of isavuconazole treatment in German hospitals

Kron, Florian; Wingen-Heimann, Sebastian M; Jeck, Julia; Lazzaro, Carlo; Cornely, Oliver A.; Thielscher, Christian

doi:10.1111/myc.13192

Cited by 6 publications

(12 citation statements)

References 27 publications

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“…Cost savings for the administration of ISA in the inpatient setting were found for patients with an allogeneic HSCT and AML across all analysed codes in Spain and England (AP‐GRD and HRG, respectively). By comparing the analysis at hand with the study by Kron et al, 9 it could be confirmed that the administration of ISA for the defined patient cohort leads to cost savings in England and Spain as well, due to a full reimbursement and despite a different structural orientation of the underlying healthcare system 9 …”

Section: Discussionmentioning

confidence: 84%

“…ISA thus is beneficial from both a medical and a hospital management perspective. Focussing on the German Bismarck study, Kron et al 9 described that drug costs for the administration of ISA are not automatically reimbursed and cost coverage depends on a highly bureaucratic negotiation process 9 . With regard to the study at hand, complex negotiations between healthcare providers (Germany) / Ministry of Health (Spain and England) and the pharmaceutical companies were not country‐specific but affected all healthcare system designs in Europe.…”

Section: Discussionmentioning

confidence: 99%

“…The administration of ISA in on a highly bureaucratic negotiation process. 9 With regard to the study at hand, complex negotiations between healthcare providers (Germany) / Ministry of Health (Spain and England) and the pharmaceutical companies were not country-specific but affected all healthcare system designs in Europe.…”

Section: Discussionmentioning

confidence: 99%

“…The study was conducted based on study results by Kron et al, 9 which analysed cost-containment and reimbursement strategies of isavuconazole (ISA) as an example for innovative antifungal treatment regimens for IA and IM in Germany. 9 To reveal potential differences and incentives in the reimbursement of innovative products compared to other countries, the primary aim of this study was to analyse the market access process and reimbursement of ISA in England and Spain. Focussing on these countries was particularly interesting as both are representatives of Beveridge-based healthcare systems and are thus structured fundamentally differently to Germany (Bismarckbased).…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Reimbursement of innovative pharmaceuticals in English and Spanish hospitals—The example of isavuconazole

Jeck

Wingen-Heimann

Thielscher

et al. 2021

Mycoses

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Background Kron et al (Mycoses, 64, 2021, 86) found cost savings for the use of the innovative pharmaceutical isavuconazole in the inpatient setting in Germany (Bismarck‐based healthcare system). Little is known about the reimbursement of innovative pharmaceuticals in the inpatient setting of Beveridge‐based healthcare systems. Objectives The aim of this study was to evaluate the market access process and reimbursement of isavuconazole, exemplary for innovative pharmaceuticals, in England and Spain. Patients/Methods Market access processes of both countries were described. Focussing on typical patient clusters for isavuconazole treatment, reimbursement data regarding inpatients with (i) allogeneic haematopoietic stem cell transplantation or (ii) acute myeloid leukaemia was considered. Data were publicly available and of high topicality (England 2020/2021, Spain 2018). Discounting and a currency conversion to Euro were applied. Results This study showed that market access processes of both countries are broadly similar. Further, full reimbursement of isavuconazole as an innovative pharmaceutical may lead to reduction in resource utilisation. Without medication costs, isavuconazole can thus result in cost savings for both patient clusters due to a reduction in length of stay. Conclusions Expenses for innovative pharmaceuticals may be balanced or even lead to cost savings due to a reduction in length of stay. The latter contributes to a greater patient benefit. For both healthcare system, the analyses highlighted drugs’ cost‐effectiveness and assessing its added value into reimbursement decisions is highly relevant.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Reimbursement of innovative pharmaceuticals in English and Spanish hospitals—The example of isavuconazole

Jeck

Wingen-Heimann

Thielscher

et al. 2021

Mycoses

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Ökonomische Analyse der molekularen Diagnostik beim nichtkleinzelligen Lungenkarzinom – Eine Bestandsaufnahme der Versorgungs- und Vergütungssituation in der deutschen Krankenhauslandschaft

Kurte

Siefen²,

Dengler

et al. 2023

Gesundheitsökonomie & Qualitätsmanagement

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Zusammenfassung Hintergrund Seit 2009 führen zielgerichtete Therapien gegen molekulare Tumoreigenschaften des nichtkleinzelligen Lungenkarzinoms zu signifikanten Verbesserungen des Gesamtüberlebens. Aktuelle Erhebungen der Testraten der dafür obligaten molekularpathologischen Diagnostik zeigen hingegen niedrige Quoten auf. Während im ambulanten Sektor eine Abrechnungsmöglichkeit für die molekulare Diagnostik besteht, wird die fehlende Vergütung im stationären Fallpauschalensystem als Hürde diskutiert. Methode Ziel der Analyse war, die Versorgungs- und Vergütungsstrukturen der molekularen Diagnostik in Deutschland zu erheben. Hierzu wurden der Versorgungspfad und die Abrechnungsmöglichkeiten der molekularen Diagnostik systematisch und qualitativ aufgearbeitet. Im Deutschen Krankenhausverzeichnis wurden quantitativ alle Krankenhäuser erhoben, die Patienten/-innen mit der ICD-10 Diagnose „Lungenkrebs“ behandeln. Diesen Krankenhäusern wurden die zutreffenden ambulanten Abrechnungsmöglichkeiten zugeordnet. Ergebnisse Eine ambulante Abrechnungsmöglichkeit für die molekulare Diagnostik wurde über eine Teilnahme an der vertragsärztlichen Versorgung inklusive medizinischer Versorgungszentren, der ambulanten Behandlung am Krankenhaus, der ambulanten spezialfachärztlichen Versorgung, eine Hochschulambulanz oder eine Teilnahme an einem Vertrag der Besonderen Versorgung definiert. An 1.001 Krankenhausstandorten (889 Krankenhäuser) wurden im Jahr 2020 Lungenkrebspatienten/-innen behandelt. 52% der Krankenhäuser haben keine ambulante Abrechnungsmöglichkeit (n=462), wovon 89%≤500 Betten (n=413) aufweisen. Von 171.824 Krankenhausfällen wurden 32% (n=55.826) in Krankenhäusern ohne ambulante Abrechnungsmöglichkeit behandelt, davon entfielen 81% auf Krankenhäuser≤500 Betten (n=45.260). Schlussfolgerung Krankenhäuser ohne ambulante Abrechnungsmöglichkeit der molekularen Diagnostik könnten aufgrund der nicht kostendeckenden stationären Vergütung einem ökonomischen Fehlanreiz unterliegen. Innovative Versorgungskonzepte zeigen Möglichkeiten einer qualitätsgesicherten, sektorenunabhängigen Vergütung auf. Ein Transfer in die Regelversorgung könnte die Fehlanreize beheben.

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Examining the effect of financial accounting services on the financial performance of SME: The function of information technology as a moderator

Gyamera

Atuilik²,

Eklemet

et al. 2023

Cogent Business & Management

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Principal‐agent theory‐based cost and reimbursement structures of isavuconazole treatment in German hospitals

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 27 publications

Reimbursement of innovative pharmaceuticals in English and Spanish hospitals—The example of isavuconazole

Reimbursement of innovative pharmaceuticals in English and Spanish hospitals—The example of isavuconazole

Ökonomische Analyse der molekularen Diagnostik beim nichtkleinzelligen Lungenkarzinom – Eine Bestandsaufnahme der Versorgungs- und Vergütungssituation in der deutschen Krankenhauslandschaft

Examining the effect of financial accounting services on the financial performance of SME: The function of information technology as a moderator

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