Biomedical subjects

O Schöffski

Publications and source records attributed to O Schöffski.

4 recordsLinked to original sources

PubMed1998

[Cost-effectiveness--limits between optimization and rationing].

Although rationing is an important feature in the German health care system, this topic is not discussed in an explicit and structured way. Currently, most rationing decisions are not based on systematic data on costs and outcomes of diseases and medical interventions. A major task of future research will be to provide health policy makers with data on direct costs, indirect costs, effectiveness, and utility of medical interventions and to integrate these data into decision analysis models. Interdisciplinary work-groups should be set up, combining clinical and economic knowledge. On the other hand, official grants are needed to perform unbiased research in this field covering the various areas of medical care.

Cost-Benefit Analysis↗

PubMed1998

What is Germany's experience on reference based drug pricing and the etiology of adverse health outcomes or substitution?

Germany is frequently cited as an example of reference based pricing (RBP) in ongoing controversial discussions on the effect of RBP. There are thorough analyses of phase I and II RBP on Germany's drug market. However, any conclusions on the overall economic and public health impact of RBP, solely on the basis of aggregated data, must be suspect to substantial bias, since too many factors in a rapidly changing health care system remained uncontrolled. Parallel to the introduction of phase II RBP in 1992/1993, the second health care reform became active. The two major confounding factors were the introduction of fixed drug budgets and the many changes due to the unification of Germany that took place in the beginning of the 1990s. Published and unpublished aggregated data do not allow any conclusions on the etiology of adverse health events due to this change in drug reimbursement policy. Conclusions drawn from the German experience will be based on assumptions or speculations that are hard to prove. A health care system that identifies enough evidence and need to introduce RBP as a measure of cost control should make every effort to evaluate the effects in order to increase program compliance or, if indicated, make adaptations to the RBP policy. The introduction of RBP in British Columbia in 1995-1997 and its computerized administrative health databases covering a large proportion of the population should give rise to a thorough analysis of this policy.

Canada↗

PubMed1997

Unintended effects of a cost-containment policy: results of a natural experiment in Germany.

In this paper empirical evidence for substitution processes caused by the budget for drugs prescribed by office-based physicians is provided. Due to substitution processes in a natural experiment the number of referrals and hospital admissions increased significantly after the introduction of a drug budget in Germany. This leads to additional direct and indirect cost for the health care system.

Budgets↗

PubMed1996

Consequences of implementing a drug budget for office-based physicians in Germany.

For many years, drug prices in Germany were the highest in Europe and the level of regulation of the pharmaceutical industry was lower than in other states. This situation has, however, changed radically in recent years. Pharmaceutical prices have been regulated, without the introduction of direct price controls, through a combination of pressures exerted by the authorities and the German sickness funds, which are responsible for reimbursement. The process of price restriction began in 1984 with the imposition of a negative pharmaceuticals list, which was further extended in 1989. A reference pricing system was also introduced in 1989, and a drug budget for office-based physicians in 1993. An overview of these measures is provided in the first section of this article. This is followed by a report of a study of the impact of Germany's global pharmaceutical budgets for office-based general practitioners and internists.

Budgets↗