Universität zu Köln

Kron, Florian, Wingen-Heimann, Sebastian M., Jeck, Julia, Lazzaro, Carlo ORCID: 0000-0003-4795-1834, Cornely, Oliver A. and Thielscher, Christian (2021). Principal-agent theory-based cost and reimbursement structures of isavuconazole treatment in German hospitals. Mycoses, 64 (1). S. 86 - 95. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Background Isavuconazole (ISA) is a frequently used antifungal agent for the treatment of invasive fungal diseases (IFDs). However, hospital reimbursement data for ISA is limited. Objectives The primary objective of this study was to analyse the different perspectives of relevant stakeholders and the (dis)incentives for the administration of ISA in Germany. To that aim, the health economic effects of using ISA from a hospital management perspective were analysed. Patients/Methods Based on principal-agent theory (PAT), the perspectives of (a) the patient (principal) as well as (b) physicians, (c) pharmacists and iv. hospital managers (all agents) were analysed. For the evaluation of the cost-containment and reimbursement strategies of ISA, the German diagnosis-related group (G-DRG) system was used. Results Hospitals individually negotiating additional payments for innovative treatment procedures (zusatzentgelte [ZE]) within the G-DRG system is a key element of hospital management for the reduction of total healthcare expenditure. Our analysis demonstrated the beneficial role of ISA in healthcare resource utilisation, primarily due to a shortened overall length of hospital stay. Depending on underlying disease, coded G-DRG and ISA formulation, large differences in total reimbursement and the amount of ZE was shown. The PAT demonstrated disincentives for hospital managers to use innovative drugs. Conclusions Based on the PAT, beneficial, detrimental and indifferent perspectives of different stakeholders regarding the usage of ISA were shown. A reduction of bureaucratic hurdles is needed in Germany for the extension of effective and innovative antifungal treatment strategies with ISA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kron, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wingen-Heimann, Sebastian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jeck, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Lazzaro, Carlo UNSPECIFIED orcid.org/0000-0003-4795-1834 UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thielscher, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-314907
DOI:	10.1111/myc.13192
Journal or Publication Title:	Mycoses
Volume:	64
Number:	1
Page Range:	S. 86 - 95
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFECTIOUS-DISEASES SOCIETY; INVASIVE MOLD INFECTIONS; PRACTICE GUIDELINES; ASPERGILLOSIS; VORICONAZOLE; UNCERTAINTY; MANAGEMENT; DIAGNOSIS; QUALITY; SECURE Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31490