Principal-agent theory-based cost and reimbursement structures of isavuconazole treatment in German hospitals

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Florian Kron1,2,3,4, Sebastian M Wingen-Heimann1,2,3, Julia Jeck3

  • 1FOM University of Applied Sciences, Cologne, Germany.

Mycoses
|October 9, 2020
PubMed
Abstract

Insights

Isavuconazole (ISA) offers benefits in treating invasive fungal diseases (IFDs) by shortening hospital stays. However, principal-agent theory reveals disincentives for hospital managers, necessitating reduced bureaucracy for wider ISA use in Germany.

Area of Science:

  • Pharmacoeconomics
  • Health Services Research
  • Antifungal Therapy

Background:

  • Isavuconazole (ISA) is a key antifungal for invasive fungal diseases (IFDs).
  • Limited hospital reimbursement data exists for ISA.
  • Understanding stakeholder perspectives is crucial for ISA administration.

Purpose of the Study:

  • Analyze stakeholder perspectives on Isavuconazole (ISA) administration in Germany.
  • Identify incentives and disincentives for ISA use from a hospital management viewpoint.
  • Evaluate the health economic effects of ISA within the German healthcare system.

Main Methods:

  • Applied principal-agent theory (PAT) to analyze patient, physician, pharmacist, and hospital manager perspectives.
  • Utilized the German diagnosis-related group (G-DRG) system for evaluating reimbursement strategies.
  • Assessed cost-containment and resource utilization associated with ISA.

Main Results:

  • ISA use is linked to shorter hospital stays, improving healthcare resource utilization.
  • Negotiating additional payments (zusatzentgelte) is a key hospital management strategy.
  • Principal-agent theory identified disincentives for hospital managers regarding innovative drug adoption.
  • Reimbursement and additional payments for ISA varied significantly based on disease, G-DRG, and formulation.

Conclusions:

  • Stakeholder perspectives on ISA usage are mixed, with beneficial, detrimental, and indifferent viewpoints identified.
  • Reducing bureaucratic hurdles is essential for expanding the use of innovative antifungals like ISA.
  • Streamlining processes can facilitate effective antifungal treatment strategies in Germany.
Keywords:
G-DRGInvasive fungal diseasesadditional paymentsantifungal treatmentsaspergillosiscostshospital reimbursementisavuconazolemycosis

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