Inhalt des Dokuments
Perspektiven der Verblisterung von Arzneimitteln in Deutschland
|Autor||Blankart C, von
German Research Articles 2008; 6(2):
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Perspectives of dose-dispensed medicine
(DDM) in Germany
Background & Methods: In the last two decades dose-dispensed medicine (DDM) has increasingly been discussed and tested as an alternative to the traditional distribution and intake of medicine. Studies report that DDM promises several advantages to patients. Besides convenience it also improves compliance and thus reduces complications. These effects will not only improve patient care and satisfaction but also contribute to reducing health care expenditures, e. g. avoiding re-hospitalisation due to mproved compliance.
A closer review, however, reveals that the studies do not always clearly distinguish between costs with, and costs without, DDM. Some authors also argue that DDM does not reach the appropriate patient population. Still others claim that the extra costs of DDM exceed the respective cost savings and that, somewhat paradoxically, DDM might become a source of monopolistic market power. This paper can be understood as a meta-study, building on and evaluating existing studies to develop a new and more comprehensive view on the impact of DDP in Germany.
Conclusions: The authors of the present study find that substantial cost reductions can indeed be expected from introducing DDM. Despite some mismatch, users as a whole are likely to benefit. Mismatch can be contained by targeted subsidies in the sense of a second best strategy. Moreover, transitory subsidies can be justified as a dynamic market-penetrating strategy. The argument that DDM might become a source of monopolistic market power has been found to be unsubstantiated. The pricing of DDM and possible subsidies should be jointly evaluated by policy makers, insurance companies and providers. The authors propose a more dynamic approach to DDM. Decision makers should not only rely on static cost-benefit analyses but should use the market to discover the actual costs and benefits of DDM. The time has come for a market test.