Mueller Edgar A, Kirch Wilhelm
Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden, Fiedlerstrasse 27, 01307, Dresden, Germany, Edgar.
Med Klin (Munich). 2008 Oct 15;103(10):712-6. doi: 10.1007/s00063-008-1111-2. Epub 2008 Oct 21.
A new German law introduced the cost-effectiveness evaluation of drugs. In Germany, the Institute for Quality and Efficiency in Health Care (IQWiG) is responsible for such evaluations. Currently, however, there is a heavy and controversial debate about the correct method to be applied. A recent proposal of IQWiG on the method to be used for cost-effectiveness evaluations has been dismissed by an expert panel. Moreover, previous IQWiG assessments are criticized and the institute is accused of providing insufficient transparency of its evaluation procedures. The head organizations of the compulsory health insurances focus on their own method to analyze and judge new drugs (EVITA), which is claimed to provide the desired results faster than IQWiG. In Germany, the current situation appears obscure and there is the threat of confusing and contradictory methods for cost-effectiveness evaluations yielding inconsistent assessments.
This paper aims at outlining the current situation in Germany and providing potential solutions.
It requires an early and multidisciplinary collaboration to achieve the goal of a valid and fully transparent cost-effectiveness evaluation.
德国一项新法律引入了药物的成本效益评估。在德国，医疗保健质量与效率研究所（IQWiG）负责此类评估。然而，目前对于应采用的正确方法存在激烈且有争议的辩论。IQWiG最近关于成本效益评估方法的提议已被一个专家小组驳回。此外，IQWiG之前的评估受到批评，该机构被指责其评估程序缺乏足够的透明度。法定医疗保险的主要组织专注于自己分析和评判新药的方法（EVITA），据称该方法能比IQWiG更快地得出预期结果。在德国，当前形势似乎不明朗，存在成本效益评估方法混乱且相互矛盾，从而产生不一致评估结果的风险。
本文旨在概述德国的当前形势并提供潜在解决方案。
要实现有效且完全透明的成本效益评估目标，需要早期的多学科合作。
