Healthcare reform and expenditure on drugs. The German situation.

Abstract:

:Germany is in a period of transition with regard to healthcare reform. The number and intensity of cost control interventions increased during the last decade in an attempt to contain healthcare expenditure. The German legislature has implemented long term macroeconomic measures such as contribution rate stability and global budgeting. The mid-term goal is to reduce the structural deficits of the current system. This paper argues that reference prices, introduced in the 1989 Healthcare Reform Act, did not produce the expected savings. An analysis of the effects of the 1993 Healthcare Structure Act on pharmaceutical expenditure is also presented. Compared with the implementation of the reference price system, the introduction of global budgeting in 1993 has had a more effective and lasting cost-containment impact. The paper concludes with a review of the main aspects of the current reform discussion.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Ulrich V,Wille E

doi

10.2165/00019053-199600102-00013

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

81-8

eissn

1170-7690

issn

1179-2027

journal_volume

10 Suppl 2

pub_type

杂志文章
  • Utilities of the EQ-5D: transferable or not?

    abstract:BACKGROUND:Within the framework of economic evaluations, the transferability of utility scores between jurisdictions remains unclear. The EQ-5D is a generic instrument for measuring health-related quality of life in economic evaluations, which can be used for comparing utility scores across countries. At present, the E...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/11314120-000000000-00000

    authors: Knies S,Evers SM,Candel MJ,Severens JL,Ament AJ

    更新日期:2009-01-01 00:00:00

  • Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients.

    abstract::Fluconazole (FLU) is an alternative to amphotericin B (AMB) for the treatment of candidemia in non-neutropenic patients. This agent has similar clinical efficacy but significantly reduced adverse effects compared with AMB. Using the database from a Canadian randomised multicentre comparative trial of FLU versus AMB in...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2165/00019053-199813050-00004

    authors: Dranitsaris G,Phillips P,Rotstein C,Puodziunas A,Shafran S,Garber G,Smaill F,Salit I,Miller M,Williams K,Conly J,Singer J,Ioannou S

    更新日期:1998-05-01 00:00:00

  • Changing therapeutic regimens in benign prostatic hyperplasia. Clinical and economic considerations.

    abstract::About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been i...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200119020-00003

    authors: Stoevelaar HJ,McDonnell J

    更新日期:2001-01-01 00:00:00

  • Economic evaluation of a new acellular vaccine for pertussis in Canada.

    abstract:OBJECTIVE:Pertussis is a highly contagious infection affecting mainly children. Acellular pertussis vaccines were recently introduced in Canada based on evidence of improved safety and efficacy over whole cell vaccines, the current standard of care. The following study reports the economic impact of replacing the whole...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200119050-00009

    authors: Iskedjian M,Einarson TR,O'Brien BJ,De Serres JG,Gold R,Gemmill IM,Milkovich N,Rosner A

    更新日期:2001-01-01 00:00:00

  • Economic aspects of pharmacotherapy for chronic constipation.

    abstract::Constipation is one of the most common digestive complaints. It is a symptom, not a disease. The subjectivity that this involves means that assessments of clinical epidemiology, socioeconomic costs and pharmacotherapy are difficult, since there is no definition of 'normal' bowel habit. Although constipation can affect...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199507010-00003

    authors: Passmore AP

    更新日期:1995-01-01 00:00:00

  • The role of pharmacoeconomic evaluations in disease management.

    abstract::Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage over the current component...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199814010-00002

    authors: Chang K,Nash D

    更新日期:1998-07-01 00:00:00

  • Granisetron. A pharmacoeconomic evaluation of its use in the prophylaxis of chemotherapy-induced nausea and vomiting.

    abstract::The efficacy of granisetron in preventing acute nausea and vomiting during the 24 hours following chemotherapy in patients with cancer is equivalent to that of other serotonin 5-HT3 receptor antagonists (ondansetron and tropisetron) and similar to or greater than that of conventional antiemetic regimens such as metocl...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199609040-00009

    authors: Plosker GL,Benfield P

    更新日期:1996-04-01 00:00:00

  • Interferon-beta in multiple sclerosis. Can we control its costs?

    abstract::The recent licensing of interferon-beta for use in patients with multiple sclerosis has caused concern, in view of the equivocal evidence of efficacy, pressure of public expectation towards its use and the high expected cost if widespread use were to be sanctioned. Whether such alarm is justified remains a moot point....

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199711030-00002

    authors: Tolley KH,Whynes DK

    更新日期:1997-03-01 00:00:00

  • Decision analysis in formulary decision making.

    abstract::Although decision making about what drugs to include in an institutional formulary appears to lend itself readily to quantitative techniques such as decision analysis and cost-benefit analysis, a review of the literature reveals that very little has been published in this area. Several of the published decision analy...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199303060-00005

    authors: Schechter CB

    更新日期:1993-06-01 00:00:00

  • Cost-effectiveness analysis of hepatitis B vaccination strategies in Catalonia, Spain.

    abstract::Hepatitis B virus (HBV) infection is an important public health problem all over the world. Vaccination is one way to prevent it, and several strategies can be used depending on endemicity, the main pattern of HBV transmission and the demographic structure of the population. In this study, an economic comparison of 3 ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199507050-00007

    authors: Antoñanzas F,Garuz R,Rovira J,Antón F,Trinxet C,Navas E,Salleras L

    更新日期:1995-05-01 00:00:00

  • EQ-5D Utilities in Chronic Spontaneous/Idiopathic Urticaria.

    abstract:OBJECTIVES:To obtain utility estimates suitable for use in economic models for chronic spontaneous (idiopathic) urticaria (CSU). METHODS:Patient-level data from three randomized clinical trials-ASTERIA I, ASTERIA II and GLACIAL-were analysed. Health states were derived from the Urticaria Activity Score over 7 days (UA...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-015-0375-7

    authors: Hawe E,McBride D,Balp MM,Tian H,Halliday A,Stull DE

    更新日期:2016-05-01 00:00:00

  • Cost considerations in the pharmacological prevention and treatment of stroke.

    abstract::Stroke remains the leading cause of neurological disability and the third leading cause of death worldwide, consuming a large share of total healthcare expenditures. In this review, we discuss the cost effectiveness of stroke prevention for various risk factor-modification programmes and pharmacological interventions ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199711050-00004

    authors: Alexandrov AV,Smurawska LT,Bartle W,Oh P

    更新日期:1997-05-01 00:00:00

  • The state of health economic research in South Africa: a systematic review.

    abstract:BACKGROUND:Economic factors are a limiting factor toward the implementation of many health programmes and interventions. Economic evaluation has a great potential to contribute toward cost-effective healthcare delivery in South Africa. Little is known about the characteristics and quality of health economic (including ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/11589450-000000000-00000

    authors: Gavaza P,Rascati KL,Oladapo AO,Khoza S

    更新日期:2012-10-01 00:00:00

  • Evolocumab for Treating Primary Hypercholesterolaemia and Mixed Dyslipidaemia: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    abstract::As part of its Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of evolocumab (Amgen) to submit evidence on the clinical and cost effectiveness of evolocumab. The appraisal assessed evolocumab as monotherapy or in combination with a statin...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-016-0472-2

    authors: Carroll C,Tappenden P,Rafia R,Hamilton J,Chambers D,Clowes M,Durrington P,Qureshi N,Wierzbicki AS

    更新日期:2016-11-16 00:00:00

  • Pharmacoeconomic analysis of oral antifungal therapies used to treat dermatophyte onychomycosis of the toenails. A US analysis.

    abstract::Until a few years ago, griseofulvin and ketoconazole were the only 2 oral agents available for the treatment of dermatophyte onychomycosis of the toenails. With the availability of the newer antifungal agents, such as itraconazole, terbinafine and fluconazole, the armamentarium of drugs available to treat onychomycosi...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199813020-00007

    authors: Gupta AK

    更新日期:1998-02-01 00:00:00

  • The value of clopidogrel in addition to standard therapy in reducing atherothrombotic events.

    abstract::The recent multinational, randomised, prospective studies Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE), Percutaneous Coronary Intervention substudy of CURE (PCI-CURE) and Clopidogrel for the Reduction of Events During Observation (CREDO) have demonstrated the clinical efficacy and safety of clopid...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,meta分析,多中心研究

    doi:10.2165/00019053-200422004-00006

    authors: Weintraub W,Jönsson B,Bertrand M

    更新日期:2004-01-01 00:00:00

  • A Markov process analysis comparing the cost effectiveness of maintenance therapy with citalopram versus standard therapy in major depression.

    abstract::The objective of this study was to demonstrate the cost effectiveness of long term maintenance treatment with citalopram versus standard therapy (defined as short term antidepressant treatment) in patients with major depression in Germany. We chose doxepin, amitriptyline and trimipramine as standard therapy because th...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199508020-00007

    authors: Nuijten MJ,Hardens M,Souêtre E

    更新日期:1995-08-01 00:00:00

  • A methodological review of models used to estimate the cost effectiveness of antiretroviral regimens for the treatment of HIV infection.

    abstract::The aim of this article was to perform a detailed methodological review of models used to estimate the cost effectiveness of drug treatment regimens for HIV infection in Europe and North America and assess the relationship between the different modeling approaches or key structural assumptions and the results. Electro...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-013-0098-6

    authors: Mauskopf J

    更新日期:2013-11-01 00:00:00

  • The economics of a pharmacy-based central intravenous additive service for paediatric patients.

    abstract::This study was designed to compare the costs of a pharmacy-based Central Intravenous Additive Service (CIVAS) with those of traditional ward-based preparation of intravenous doses for a paediatric population. Labour costs were derived from timings of preparation of individual doses in both the pharmacy and ward by an ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199610040-00007

    authors: Armour DJ,Cairns CJ,Costello I,Riley SJ,Davies EG

    更新日期:1996-10-01 00:00:00

  • A pharmacoeconomic model for the treatment of influenza.

    abstract:OBJECTIVE:The aim of this study was to develop a generic treatment algorithm for influenza and influenza-like illness (ILI) that could be used to estimate the costs and outcomes of current and new treatments for influenza in different countries for different patient subgroups. METHODS:A series of possible treatment pa...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199916001-00010

    authors: Mauskopf JA,Cates SC,Griffin AD

    更新日期:1999-01-01 00:00:00

  • Estimating the cost effectiveness of atovaquone versus intravenous pentamidine in the treatment of mild-to-moderate Pneumocystis carinii pneumonia.

    abstract::Pneumocystis carinii pneumonia (PCP) is the most common severe opportunistic infection, and one of the most costly, among people with AIDS. Over 50% of patients experience toxic effects of the major anti-PCP medications- cotrimoxazole (trimethoprim-sulfamethoxazole) and pentamidine. Recently, the US Food and Drug Admi...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00019053-199609060-00007

    authors: Zarkin GA,Bala MV,Wood LL,Bennett CL,Simpson K,Dohn MN

    更新日期:1996-06-01 00:00:00

  • Cost effectiveness of targeted high-dose atorvastatin therapy following genotype testing in patients with acute coronary syndrome.

    abstract:BACKGROUND:Results from the PROVE IT trial suggest that patients with acute coronary syndrome (ACS) treated with atorvastatin 80 mg/day (A80) have significantly lower rates of cardiovascular events compared with patients treated with pravastatin 40 mg/day (P40). In a genetic post hoc substudy of the PROVE IT trial, the...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40273-013-0054-5

    authors: Parthan A,Leahy KJ,O'Sullivan AK,Iakoubova OA,Bare LA,Devlin JJ,Weinstein MC

    更新日期:2013-06-01 00:00:00

  • Measuring the effect of cancer on health-related quality of life.

    abstract::Measuring health-related quality of life in patients with cancer has focused primarily on the development of reliable and valid instruments (questionnaires), and on the effect of chemotherapy in phase III clinical trials. From this research several important lessons have emerged, such as: (i) the need to measure multi...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199507040-00005

    authors: Osoba D

    更新日期:1995-04-01 00:00:00

  • An evaluation of the cost effectiveness of drotrecogin alfa (activated) relative to the number of organ system failures.

    abstract:BACKGROUND:While drotrecogin alfa (activated) was shown to decrease absolute 28-day mortality by 6.1% in patients with severe sepsis in the Recombinant Human Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study, no mortality benefit was observed in the subset of patients with only one organ system failure. C...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/BF03262331

    authors: Betancourt M,McKinnon PS,Massanari RM,Kanji S,Bach D,Devlin JW

    更新日期:2003-01-01 00:00:00

  • Review of cost-benefit analyses of influenza vaccine.

    abstract::Vaccination is an underutilised, low cost and effective method of preventing illness. Cost-effectiveness analysis discloses a beneficial role of influenza vaccination in preventing illness especially in patients over 65 years of age and in high risk patients. In one large study, when 150 million doses of influenza v...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199202030-00003

    authors: Perez-Tirse J,Gross PA

    更新日期:1992-09-01 00:00:00

  • Cost effectiveness of trastuzumab in the adjuvant treatment of early breast cancer: a lifetime model.

    abstract:BACKGROUND:Recent randomised trials have demonstrated a statistically significant effect of trastuzumab on disease-free survival when used as adjuvant therapy for human epidermal growth factor receptor 2 protein (HER2)-positive resectable early stage breast cancer, with a treatment course lasting either 9 or 52 weeks. ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200725050-00006

    authors: Millar JA,Millward MJ

    更新日期:2007-01-01 00:00:00

  • Choice of cost-effectiveness measure in the economic evaluation of cholesterol-modifying pharmacotherapy. An illustrative example focusing on the primary prevention of coronary heart disease in Canada.

    abstract:OBJECTIVE:To evaluate the effect of using different cost-effectiveness measures in the economic evaluation of cholesterol-modifying pharmacotherapy. DESIGN AND SETTING:An economic model was used to examine the extent to which the relative cost effectiveness of cholesterol-modifying agents varies depending upon the cos...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199916020-00008

    authors: Morris S,Godber E

    更新日期:1999-08-01 00:00:00

  • Economic aspects of pneumococcal pneumonia: a review of the literature.

    abstract::In this review, the economic aspects of pneumococcal pneumonia are analysed, including the costs, cost effectiveness and cost benefit of treatment and prevention. We identified eight cost-of-illness studies, 15 analyses comparing the costs of different treatment options and 15 economic evaluations of prevention that m...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200422110-00003

    authors: De Graeve D,Beutels P

    更新日期:2004-01-01 00:00:00

  • Quality of life following a change in therapy for diabetes mellitus.

    abstract:OBJECTIVE:The study objective was to evaluate and compare quality-of-life (QOL) parameters between patients with type 2 (non-insulin-dependent) diabetes mellitus who changed therapy from an oral hypoglycaemic agent (OHA) to insulin and those who remained on an OHA. DESIGN:The World Health Organization Quality of Life ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199814020-00008

    authors: Pibernik-Okanović M,Szabo S,Metelko Z

    更新日期:1998-08-01 00:00:00

  • Cost analysis of 2 empiric antibacterial regimens containing glycopeptides for the treatment of febrile neutropenia in patients with acute leukaemia.

    abstract:OBJECTIVE:Patients with cancer-associated neutropenia are at high risk of developing severe infections which can be fatal if treatment is not promptly administered. For this reason, fever is treated as soon as possible with broad spectrum antibacterial therapy. The objective of this study was to conduct a cost analysis...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00019053-199915010-00006

    authors: Bucaneve G,Menichetti F,Del Favero A

    更新日期:1999-01-01 00:00:00