Health Care Expenditures in Germany: A Macroeconomic Analysis of Long-Term Affordability (Ability-to-Pay)
In: Beate Kremin-Buch, Fritz Unger, Hartmut Walz, Eveline Häusler (eds.): Gesundheitsökonomie - Eine Langfristorientierung. Sternenfels: Verlag Wissenschaft & Praxis Dr. Brauner 2004, pp. 83-129.
Subject: It is proposed to differentiate more clearly between affordability of (or ability-to-pay for), financing of (or actual flow of funds for), and willingness-to-pay for health care. Based on a comprehensive review of the literature on growing health care expenditures and existing projections of future spending trends, an analysis is presented of the macroeconomic affordability of a two-percentage point gap between the rates of health care spending and economic growth. It is shown that affordability is highly sensitive to low economic growth rates, whereas at GDP growth rates exceeding one percent, affordability can be expected for the next several decades.
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Vor der Ökonomisierung der ADHS-Therapie? Gesundheitsökonomische Aspekte
In: Thilo Fitzner, Werner Stark (eds.) Doch unzerstörbar ist mein Wesen... Diagnose AD(H)S - Schicksal oder Chance?
Weinheim: Beltz-Verlag 2004, pp. 417-466.
Subject: Increasing relevance of health economics for health care providers and patients involved with Attention-Deficit/Hyperactivity Disorder (ADHD). An introductory text delineating some fundamental principles of economic evaluation, combined with a review of the literature on the economic implications of ADHD. It is argued that three multiplicative factors may lead to escalating costs associated with the treatment of ADHD in Germany: increasing diagnostic prevalence, growing acceptance of pharmacotherapy, and higher unit costs of novel medications.
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Dilemmata der Kosten-Nutzen-Bewertung medizinischer Innovationen.
Ärzteblatt Sachsen, 3/2004, pp. 85-89.
Subject: German pharmaceutical market dynamics and evaluation of innovative new products. New regulations, enacted with the health care reform of 2003/2004, are discussed against the background of international experience. Emphasis is placed on the "fourth hurdle" and cost-effectiveness analyses. Paper in German.
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A Cost-Utility and Cost-Effectiveness Analysis of an Acute Pain Service
Journal of Clinical Anesthesia 16 (3), May 2004, 159-167.
Subject: economic evaluation of a nurse-based acute pain service in a general hospital in Belgium.
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Affordability Sensitive To Economic Growth Rates.
Health Affairs Vol. 23 (1), January/February 2004, 276-277.
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Une Simplification Terrible?
Anmerkungen zur geplanten Nutzenbewertung von Arzneimitteln aus gesundheitsökonomischer Perspektive.
Brennpunkt Gesundheitswesen, No. 11/2003 (December 2003), 22-26.
Subject: German health care modernization act ("GKV-Modernisierungsgesetz", GMG). A critique of the approach chosen to discriminate between innovative and me-too pharmaceuticals, combined with some hints on alternatives. Paper in German.
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Zur Logik der Kosten-Effektivität: Gesundheitsökonomie und Ressourcenallokation
Deutsches Ärzteblatt 100 (No. 33), August 15, 2003: A2140-A2141.
Subject: the logic of cost-effectiveness. A brief description of the specific variant of utilitarian thought underlying the decision rules of cost-effectiveness analysis.
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Rationaler Umgang mit neuen Medikamenten: Zehn Thesen zur "Vierten Hürde" für neue Arzneimittel.
[That Infamous Fourth Hurdle: Ten Things to Consider When Regulating Reimbursement for New Drugs in Germany]
Discussion Paper No. 04, Institute for Innovation & Valuation in Health Care (InnoValHC), Wiesbaden: 2nd edition 2006/2009
(originally published as Discussion Paper, University of Applied Economic Sciences Ludwigshafen, June 30, 2003)
Subject: The “fourth hurdle” for new pharmaceutical products and its alternatives. Written for non-economists, the paper provides ten reasons why pharmaceutical markets can be regulated effectively without resorting to a “fourth hurdle”. It describes, in some detail, a feasible alternative to fourth hurdle regulation. Though available to the members of the Health Care Committee of the German Parliament, the paper apparently failed to influence the consensus negotiated by Social Democrats, Christian Democrats, and the Green Party that became the basis of the German health care modernization act (GMG) of 2003/2004.
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Naming, Classification, and Trademark Selection: Implications for Market Success of Pharmaceutical Products.
Drug Information Journal 36 (2002) 807-824.
Subject: Innovation management in the pharmaceutical industry. Successful positioning strategies increasingly need to go beyond trademark selection and branding: in certain situations, identifying an appropriate International Nonproprietary Name (INN) may be essential for classification and, hence, differentiation of new compounds.
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