Acceptance Of Telemonitoring By Health Care Professionals in Germany: A Question Of Financial Conditions

Abstract

the treatment of asthma were not accepted due to comments about population and model input, lack of statistical calculations and size of the incremental effects. Ranibizumab's results for age-related macular degeneration were not accepted because of a wrong comparator, lack of long term data, assumptions on risks and mortality, and uncertainties around health care costs and ICER sensitivity. Finally, ZiNL considered the appropriate use of alglucosidase alfa for Pompe's disease to be unsubstantiated because of the population choice for the ICER calculation and the use of a higher dose than the registered dose which was not supported by scientific data. The outcome results of alglucosidase alfa for cost-effectiveness were accepted, however. ConClusions: Although at T= 0 ZiNL provided feedback regarding the design of the outcome research study, most of ZiNL's comments were on the final methodology used. The outcome research studies were considered to be of mixed quality and the results could often not substantiate the claim of cost-effectiveness and appropriate use.objeCtives: In the UK, when a technology is recommended by the National Institute for Health and Care Excellence (NICE), the NHS is mandated to provide the funding to accommodate it within three months. Explicit in NICE's approach to health technology assessment (HTA) is the assumption that the approval of a new, cost-increasing technology will result in the displacement of an existing, less cost-effective health care programme from elsewhere in the NHS. The objective of this study is to identify the actual opportunity costs of specific NICE decisions by documenting how in practice local commissioners in Wales accommodated financial shocks arising from technology appraisals (TAs). Methods: Interviews were conducted with Finance and Medical Directors from all seven Local Health Boards (LHBs) in NHS Wales. These interviews covered prioritisation processes, as well as methods of financing NICE TAs and other financial "shocks" at each LHB. We then undertook a systematic identification of themes and topics from the information recorded. Results: The financial impact of NICE TAs is generally planned for in advance and the majority of LHBs have contingency funds available for this purpose. Efficiency savings (defined as reductions in costs with no assumed reductions in quality) were a major source of funds for all cost pressures. Service displacements were not linkable to particular TAs and there appears to be a general lack of explicit prioritisation activities. The Welsh Government has, on occasion, acted as the funder of last resort. ConClusions: The assumption that newly recommended technologies will displace existing NHS services does not appear to hold true in practice. As the additional cost pressures represented by new NICE TAs are likely to be accommodated by greater efficiency and increased expenditure, the true opportunity cost of HTA decisions is extremely difficult to quantify and may even lie outside the NHS.

Utilising Mobile Health Apps – A Comparison of GP Perceptions Across Australia and Germany

“…This included a lack of information about DiGAs and medical evidence, inadequate reimbursement for medical services, concerns about legal issues such as liability and privacy risks, and training needs, among others. These barriers are consistent with other studies about social, organisational, financial and technological factors impacting doctors' adoption of mHealth tools from different countries and settings [19,21].…”

Physicians’ Attitudes Toward Prescribable mHealth Apps and Implications for Adoption in Germany: Mixed Methods Study

“…A total of 1308 health care professionals completed the questionnaire, with minor nonresponse to individual questions, corresponding to a response rate of 7%, in line with previous research [ 23 , 32 , 33 ], making this the largest study on health care professionals’ mHealth adoption in Germany so far.…”