Böcking W, Tidelski O, Skuras B, Bäumler A, Kitzmann F
Forschungsverbund Public Health Sachsen-Sachsen Anhalt e.V., Fiedlerstrasse 27, Dresden.
Dtsch Med Wochenschr. 2012 Aug;137(31-32):1595-600. doi: 10.1055/s-0032-1305174. Epub 2012 Aug 7.
Health Insurance costs in Germany have grown constantly over the last years. This increase of costs is not only observable in the total consideration but also in all single items. An outstanding growth rate exists in the field of pharmaceutical expenses. Detailed analyses of distribution and development of these costs, separated by age and indication groups, are currently only sporadically available and mostly focusing on the Statutory Health Insurance system in Germany. This research article is based on an initial data analysis and focuses on the question how pharmaceutical expenses in a German private health insurance company will develop until the year 2050, if the observed trend of the past years continues in the same way. This analysis focuses on different age groups. The objective is the demonstration of several scenarios, which illustrate the level of influence of different parameters (demographic changes, developments of prices for pharmaceuticals). Based on the cognition of certain effects measures for handling the growing challenge of financing the health system can be deduced. As a result, both demographic changes and price effects have an significant impact on the future development of per capita pharmaceutical expenses. Whereas older age groups will still cause the highest costs, the middle-aged people will show the highest growth rates. This strong cost increase is not sustainable for the German health insurance system. In addition to previous measures of a regulatory health policy (especially improved cost-benefit-assessments) the article shows new approaches for an intensified prevention and health promotion.
在过去几年中，德国的医疗保险费用持续增长。这种成本增加不仅体现在总体费用上，而且在所有单项费用中都能观察到。药品费用领域的增长率尤为突出。目前，有关这些费用按年龄和适应症组划分的分布和发展的详细分析只是偶尔可得，并且大多集中在德国的法定医疗保险系统。这篇研究文章基于初步数据分析，关注的问题是，如果过去几年观察到的趋势以同样方式持续下去，德国一家私人健康保险公司的药品费用到2050年将如何发展。该分析聚焦于不同年龄组。目的是展示几种情景，这些情景说明了不同参数（人口结构变化、药品价格发展）的影响程度。基于对某些影响的认识，可以推导出应对卫生系统融资日益增长挑战的措施。结果表明，人口结构变化和价格效应均对人均药品费用的未来发展产生重大影响。虽然老年群体仍将导致最高成本，但中年人的成本增长率将最高。这种强劲的成本增长对德国医疗保险系统而言是不可持续的。除了以往监管卫生政策的措施（特别是改进成本效益评估）外，本文还展示了加强预防和健康促进的新方法。
