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IQWiG presents a method for evaluating the relation between cost and benefit
Date:11/30/2009

rom the societal perspective.

No general threshold level for all indications

In contrast, for example, to the National Institute for Health and Clinical Excellence (NICE) in the UK, IQWiG compares the relation between cost and benefit for each individual disease. There is no general threshold level for all indications - i.e. a uniform upper cost limit independent of the type of disease. Such a threshold would not be in keeping with the German Social Code Book. Moreover, in IQWiG's view there is a fundamental cultural difference between the two countries. Peter Sawicki is convinced that the utilitarian mindset which underpins the British approach would not be accepted in Germany. According to the Director, "This benefit maximization ethic leads, for example, to cancer patients not receiving the expensive drug Avastin, because the costs are seen as too high in relation to extending life. On the other hand, despite doubts surrounding their additional benefit, diabetes patients are prescribed insulin analogues because the higher costs seem reasonable in the face of the supposed increase in quality of life. In Germany, this would be seen as unfair."

German parallels with the Australian approach

Even if Germany is taking a different route from the UK, viewed internationally, IQWiG is certainly not entering virgin territory with its "efficiency frontier analysis". Firstly, IQWiG is using instruments that are internationally recognized in health economics. Secondly, there are in fact countries with similar procedures to the German method. There are clear parallels with Australia, the country with the longest experience in matters concerning health economic evaluation. Our counterpart in Australia, the Pharmaceutical Benefits Advisory Committee (PBAC), has been recommending maximum reimbursable prices for drugs based on the relation between cost and benefit since 1993. As IQWiG will be doing in the future, the PBAC presents t
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Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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