Rebscher H, Schellhammer S, Kopp T, Scharnetzky E
DAK Unternehmen Leben, Nagelsweg 27–31, 20097 Hamburg.
Urologe A. 2011 Dec;50(12):1584-90. doi: 10.1007/s00120-011-2733-1.
Increasing life expectancy, the introduction of costly new drugs and contributions from the health fund which do not cover overall costs, all contribute to financial problems for statutory health insurances (SHI) in oncology. Only an evidence-based approach can help to address these problems. In a first step patient-relevant benefits have to be substantiated as a necessary prerequisite for coverage of any treatment by SHIs. For products with no additional benefit compared to established forms of therapy the price will be limited by the established cost-benefit ratio. For products with additional benefits pricing is more difficult. For this situation the Institute for Quality and Efficiency in Healthcare (IQWiG) has developed general methods for the assessment of the relation of benefits to costs. Pricing based on this health economic evaluation is developed using efficiency frontier plots. However, this method is prone to manipulation and needs to be refined. Therapies without comparators, so-called soloists, cannot be priced in this way. New approaches to increase cost efficiency need to be developed in order to ensure the availability of high quality care in the future.
预期寿命的增加、昂贵新药的引入以及健康基金的 contributions（此处原文可能有误，推测为“缴款”之类意思）无法覆盖全部成本，所有这些因素都导致了肿瘤学领域法定健康保险（SHI）面临财务问题。只有基于证据的方法才能帮助解决这些问题。第一步，患者相关的获益必须得到证实，这是 SHI 承保任何治疗的必要前提。对于与既定治疗形式相比没有额外获益的产品，其价格将受既定成本效益比的限制。对于有额外获益的产品，定价则更为困难。针对这种情况，医疗保健质量与效率研究所（IQWiG）已开发出用于评估获益与成本关系的通用方法。基于这种健康经济评估的定价是使用效率前沿图来制定的。然而，这种方法容易被操纵，需要加以完善。没有对照物的治疗方法，即所谓的“独奏者”疗法，无法以这种方式定价。需要开发新的提高成本效益的方法，以确保未来高质量医疗服务的可及性。
