The Definition and Role of Quality of Life in Germany’s Early Assessment of Drug Benefit: A Qualitative Approach
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The Definition and Role of Quality of Life in Germany’s Early Assessment of Drug Benefit: A Qualitative Approach. / Lohrberg, David; Augustin, Matthias; Blome, Christine.
In: QUAL LIFE RES, Vol. 25, No. 2, 02.2016, p. 447-455.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The Definition and Role of Quality of Life in Germany’s Early Assessment of Drug Benefit: A Qualitative Approach
AU - Lohrberg, David
AU - Augustin, Matthias
AU - Blome, Christine
PY - 2016/2
Y1 - 2016/2
N2 - PURPOSE: In 2011, Germany introduced a new form of drug benefit assessment, linking reimbursement prices to drug benefit and making quality of life (QoL) one of the main benefit criteria. Thus, QoL outcomes co-determine drug prices in Germany. QoL has, however, not been defined in the regulations. This study analyzed the definition and role of QoL in Germany's drug benefit assessment. It serves as a case study on the complexity of QoL as a parameter of health technology and drug assessments, which have become mandatory in almost all industrialized countries.METHODS: In a qualitative analysis, the publicly available dossiers (summaries), dossier evaluations, protocols of the oral hearings, the final resolutions of the Federal Joint Committee (G-BA) and its rationale of all benefit assessments completed by 2013 (n = 66) were processed. Additionally, quantitative data on the decision outcomes were collected.RESULTS: Only two decisions drew on QoL outcomes as "main justifications" for additional benefit. It was due to a lack of valid and statistically significant QoL results, a deficient presentation of QoL data, or differing understandings of QoL, that QoL benefit was not demonstrated in more than two cases. While manufacturers applied wider definitions of QoL, the assessment institutions questioned evidence if it was not reported with the help of validated QoL questionnaires or deviated from their definition of QoL.CONCLUSIONS: The German experience with QoL as a drug benefit criterion highlights the importance of a clear QoL definition and according methodological regulations.
AB - PURPOSE: In 2011, Germany introduced a new form of drug benefit assessment, linking reimbursement prices to drug benefit and making quality of life (QoL) one of the main benefit criteria. Thus, QoL outcomes co-determine drug prices in Germany. QoL has, however, not been defined in the regulations. This study analyzed the definition and role of QoL in Germany's drug benefit assessment. It serves as a case study on the complexity of QoL as a parameter of health technology and drug assessments, which have become mandatory in almost all industrialized countries.METHODS: In a qualitative analysis, the publicly available dossiers (summaries), dossier evaluations, protocols of the oral hearings, the final resolutions of the Federal Joint Committee (G-BA) and its rationale of all benefit assessments completed by 2013 (n = 66) were processed. Additionally, quantitative data on the decision outcomes were collected.RESULTS: Only two decisions drew on QoL outcomes as "main justifications" for additional benefit. It was due to a lack of valid and statistically significant QoL results, a deficient presentation of QoL data, or differing understandings of QoL, that QoL benefit was not demonstrated in more than two cases. While manufacturers applied wider definitions of QoL, the assessment institutions questioned evidence if it was not reported with the help of validated QoL questionnaires or deviated from their definition of QoL.CONCLUSIONS: The German experience with QoL as a drug benefit criterion highlights the importance of a clear QoL definition and according methodological regulations.
KW - Cost-Benefit Analysis
KW - Drug Industry
KW - Germany
KW - Humans
KW - Pharmaceutical Preparations
KW - Quality of Life
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1007/s11136-015-1092-6
DO - 10.1007/s11136-015-1092-6
M3 - SCORING: Journal article
C2 - 26242250
VL - 25
SP - 447
EP - 455
JO - QUAL LIFE RES
JF - QUAL LIFE RES
SN - 0962-9343
IS - 2
ER -