TY - JOUR

T1 - Health Technology Assessments in Radiology in Germany: Lack of Demand, Lack of Supply

AU - Winkelmann, Carolin

AU - Neumann, Thomas

AU - Zeidler, Jan

AU - Prenzler, Anne

AU - Vogt, Bodo

AU - Wacker, Frank K.

PY - 2019/2/14

Y1 - 2019/2/14

N2 - Background Health technology assessments (HTAs) are an interdisciplinary method to support sustainable, evidence-based healthcare decisions. They systematically assess medical products, procedures, and technologies with respect to medical, economic, legal, social, and ethical aspects. Method This review analyzes the current use of HTAs in radiology in Germany and discusses challenges associated with HTAs. In particular, incentive structures of various players in the healthcare field involved in HTA implementation are considered for both the inpatient and outpatient sectors. Taking into account that the Joint Federal Committee (G-BA) has different authority between sectors (»ban reservation for inpatients and authorization right for outpatients), we focus on the repercussions on reimbursement for new diagnosis or treatment methods by statutory health insurance companies. Results The G-BA's authority implicitly creates a paradox in terms of incentives to implement and finance HTAs: in the outpatient sector HTAs are considered necessary to evaluate new medical services while players may not have sufficient incentive to implement and finance HTAs in the inpatient sector. Conclusion Characteristics of HTAs differ widely with respect to the items to be assessed. Therefore, an HTA for drug effectiveness is not easily transferable to radiological procedures. Within radiology, each method must be assessed individually (e.g. according to tumor stage). Despite these challenges, systematic compilation and critical assessment (regarding both cost and medical effectiveness) of available evidence should be a basic component of evidence-based radiology. As companies in healthcare fail to invest in studies that advance evidence-based radiology and considering the lack of incentive for such investments, public funding institutions need to accept the challenge to support studies that assess the benefit of radiological procedures. Key Points: HTAs should be a basic component of evidence-based radiology. G-BA's authority implicitly creates a paradox in terms of inventives to implement and finance HTAs. University hospitals and public funding institutions need to support studies that assess the benefit of radiological procedures. Citation Format Winkelmann C, Neumann T, Zeidler J etal. Health Technology Assessments in Radiology in Germany: Lack of Demand, Lack of Supply.

AB - Background Health technology assessments (HTAs) are an interdisciplinary method to support sustainable, evidence-based healthcare decisions. They systematically assess medical products, procedures, and technologies with respect to medical, economic, legal, social, and ethical aspects. Method This review analyzes the current use of HTAs in radiology in Germany and discusses challenges associated with HTAs. In particular, incentive structures of various players in the healthcare field involved in HTA implementation are considered for both the inpatient and outpatient sectors. Taking into account that the Joint Federal Committee (G-BA) has different authority between sectors (»ban reservation for inpatients and authorization right for outpatients), we focus on the repercussions on reimbursement for new diagnosis or treatment methods by statutory health insurance companies. Results The G-BA's authority implicitly creates a paradox in terms of incentives to implement and finance HTAs: in the outpatient sector HTAs are considered necessary to evaluate new medical services while players may not have sufficient incentive to implement and finance HTAs in the inpatient sector. Conclusion Characteristics of HTAs differ widely with respect to the items to be assessed. Therefore, an HTA for drug effectiveness is not easily transferable to radiological procedures. Within radiology, each method must be assessed individually (e.g. according to tumor stage). Despite these challenges, systematic compilation and critical assessment (regarding both cost and medical effectiveness) of available evidence should be a basic component of evidence-based radiology. As companies in healthcare fail to invest in studies that advance evidence-based radiology and considering the lack of incentive for such investments, public funding institutions need to accept the challenge to support studies that assess the benefit of radiological procedures. Key Points: HTAs should be a basic component of evidence-based radiology. G-BA's authority implicitly creates a paradox in terms of inventives to implement and finance HTAs. University hospitals and public funding institutions need to support studies that assess the benefit of radiological procedures. Citation Format Winkelmann C, Neumann T, Zeidler J etal. Health Technology Assessments in Radiology in Germany: Lack of Demand, Lack of Supply.

KW - efficacy analysis

KW - efficiency analysis

KW - health economics

KW - health technology assessment

KW - radiology

UR - http://www.scopus.com/inward/record.url?scp=85068122371&partnerID=8YFLogxK

U2 - 10.1055/a-0838-6253

DO - 10.1055/a-0838-6253

M3 - Article

C2 - 30763963

AN - SCOPUS:85068122371

VL - 191

SP - 635

EP - 642

JO - RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren

JF - RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren

SN - 1438-9029

IS - 7

ER -