Original Title: Arzneimittelerstattung im stationären Sektor in Österreich: Ansätze für einen transparenten und evidenzbasierten Prozess unter Berücksichtigung internationaler Erfahrungen

Authors' objectives: Given the necessarily limited healthcare resources and high healthcare expenditure, especially in the field of rare diseases and oncology, the introduction of a new cost-intensive health intervention may result in fewer available resources for other interventions and consequently, decisions have to be made between different interventions. In democratic societies, these decisions require not only the fundamental trust in the legitimacy of the responsible institutions (ministry, social security, health funds) but also the legitimacy of the decisions themselves by exposing the rationalities (principles and criteria) of these prioritisation decisions. In favour of equal access to medical services, often there are deliberative decision-making processes that seek to make public (health policy) decisions fairly, transparently, and evidence-based. The aim of the present study was to prepare a basis for discussion of a standardised, central process in favour of transparent decisions on expensive hospital drugs in Austria.

Authors' results and conclusions: In line with the concepts of the A4R and deliberative decision-making, a transparent, evidence-based, fair and efficient allocation of existing (limited) healthcare resources to justify (difficult) decisions on priorities in democracies seems indispensable. With regard to the derivation of options for action from international processes, the transferability of these processes to the Austrian context or the pragmatic feasibility of certain options for action within the existing Austrian framework conditions needs to be reflected. The present study is intended as a basis for further discussion.

Authors' methods: In a multi-stage approach, firstly the reimbursement processes (only for original preparations) in individual selected countries as well as in Austria were investigated. Secondly, the strengths and weaknesses of the elaborated processes were analysed based on predefined criteria, following the concepts of “Accountability for Reasonableness” (A4R) and “deliberative decision-making”. Thirdly, scenarios for an Austria-wide uniform reimbursement process for hospital drugs were developed.

Project Status: Completed

URL for project: https://aihta.at/page/preisbildung-und-arzneimittelerstattung-im-stationaeren-sektor-in-oesterreich-ansaetze-fuer-einen-transparenten-und-evidenzbasierten-prozess-unter-beruecksichtigung-internationaler-erfahrungen/en

Year Published: 2018

URL for published report: http://eprints.aihta.at/1183/1/HTA-Projektbericht_Nr.109.pdf

URL for additional information: http://eprints.aihta.at/1183/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Austria

Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment

Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99

Contact Name: tarquin.mittermayr@aihta.at

Contact Email: office@aihta.at