Comment on “Where's the Value in Health Care?”

Mar 1, 2007, 00:00 AM
10.1111/j.1524-4733.2006.00164.x
https://www.valueinhealthjournal.com/article/S1098-3015(10)60465-2/fulltext
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Section Order : 9
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To the Editor—Hay [1] states in his latest article on the value of health care that the German savings of $19 billion for drugs in 2002 turned into a $3 billion net loss when indirect effects, for instance, German pharmaceutical manufacturers losing pace with rivals elsewhere, were considered as well. Clearly, Hay does not scrutinize the study of the consultant Bains, which he cited. It is conceded that German health insurers pay high prices for new and innovative drugs. Yet pharmaceutical manufacturers have been making relatively high profits through “me-too” drugs. This was an incentive to perform low-end research in me-too drugs and to refrain from high-end research in the development of fully new drugs. As the annual national report on prescriptions of medications [2] shows, only 42% of the innovations in the German drug market are true innovations. Another 18% are improved active agents. Thus, about 40% of the innovations are mere pseudo-innovations that are no better for the patient, but simply more expensive for the health insurance. Therefore, only the new system acts as an inducement to concentrate on high-end research and, consequently, to keep track with foreign competitors. In addition, it is saving money, even in net and gross, if calculated from the society’s perspective.—Markus Lungen, Ph.D., and Andreas Gerber, M.D., Institute of Health Economics and Clinical Epidemiology, University of Cologne, Koeln, Germany.

References
1 Hay JW. Where’s the value in health care. Value Health 2006;9:141–3.
2 Schwabe U, Paffrath D. Arzneiverordnungs-Report 2005. Heidelberg: Springer, 2006.
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