Lauer Wolfgang, Löbker Wiebke, Höfgen Barbara
Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Kurt-Georg-Kiesinger-Allee 3-5, 53175, Bonn, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Oct;64(10):1232-1240. doi: 10.1007/s00103-021-03409-7. Epub 2021 Sep 16.
With the Digital Health Care Act (DVG), the legislator has made it possible for digital health applications (DiGA) to be included in standard care and reimbursement in accordance with the Fifth Book of the German Social Code (SGB V). The prerequisite for the "app on prescription" is a listing in the DiGA directory after a positive evaluation procedure at the Federal Institute for Drugs and Medical Devices (BfArM). In addition to comprehensive quality and safety parameters, the manufacturers must also prove a positive healthcare effect.With the DiGA directory, the BfArM has been offering addressee-oriented comprehensive transparency on DiGA and their properties since October 2020. The article explains the path to the app on prescription from the support and advisory services offered by the BfArM to the evaluation procedure (DiGA Fast Track) and the evaluation criteria to the contents of the directory. It can be seen that there is great interest in the Fast Track procedure. The evidence of positive healthcare effects, i.e. an actual added value for patients, is balanced and at an appropriate level with predominantly randomised controlled trial evidence. The fact that the procedure can also be associated with challenges for the applicants, e.g. to adequately address deficiencies in the legally prescribed assessment period, is indicated by the numbers of withdrawn applications in relation to the listed DiGA. The BfArM is in close exchange with all parties involved regarding this new procedure. The conclusion of this article shows which considerations and potentials result from this for further development from the point of view of the BfArM.
通过《数字医疗保健法》(DVG),立法者使数字健康应用程序(DiGA)能够根据德国社会法典第五卷(SGB V)纳入标准护理和报销范围。“处方应用程序”的前提是在联邦药品和医疗器械研究所(BfArM)经过积极评估程序后列入DiGA目录。除了全面的质量和安全参数外,制造商还必须证明其具有积极的医疗保健效果。自2020年10月以来,BfArM通过DiGA目录,提供了面向收件人的关于DiGA及其特性的全面透明度。本文解释了从BfArM提供的支持和咨询服务到评估程序(DiGA快速通道)、评估标准再到目录内容的“处方应用程序”之路。可以看出,人们对快速通道程序非常感兴趣。积极医疗保健效果的证据,即对患者的实际附加值,是平衡的且处于适当水平,主要基于随机对照试验证据。从撤回申请与已列出的DiGA数量的关系可以看出,该程序也可能给申请人带来挑战,例如要充分解决法定评估期内的缺陷。BfArM就这一新程序与所有相关方保持密切交流。本文的结论展示了从BfArM的角度来看,这会为进一步发展带来哪些考虑因素和潜力。