[10 years of assessing prevention and early diagnosis programmes by the Federal Joint Committee of Germany - a...

Medical benefit is the crucial factor in the evidence-based decision-making process of the Federal Joint Committee (G-BA) of Germany. To review the decisions on population-based screening methods from January 2000 to December 2009, we analysed the coverage decisions. During this period of time, the G-BA decided on 14 screening methods, predominantly dealing with the early diagnoses of serious diseases. In 8 cases a positive assessment led to reimbursement by the statutory health insurance funds, in 5 cases the assessment was negative and in one case the conditions were changed. For 7 assessments, a fully reported review was available, 4 of this were positively evaluated. In 2 of these cases, controlled screening studies documented the benefit of the screening method. In another case there was only a case series without a control group. For the fourth method, the question for the benefit of the screening method was divided into 3 sub questions, investigated separately in different studies. The methods of benefit assessments have changed very much over time. A revision of the rules of procedure for the assessment of medical screening methods is advisable.