A precise performance-based reimbursement model for the multi-centre NAPKON cohorts - development and evaluation.

Area of Science:

• Health Economics
• Clinical Trial Management
• Health Services Research

Background:

• Fair funding allocation in multi-centre clinical studies is complex.
• Existing models like fixed-rate (FRM) and up-front allocation (UFAM) in Germany lack transparency and adaptability to centre performance variations.

Purpose of the Study:

• To develop and evaluate a performance-based reimbursement model (PBRM) for multi-centre clinical studies.
• To compare the PBRM's cost-efficiency against FRM and UFAM using data from the National Pandemic Cohort Network (NAPKON).

Main Methods:

• Developed a PBRM with automated calculation of conducted activities based on validated study protocol data.
• Applied the PBRM to NAPKON cohorts within the Network of University Medicine (NUM).
• Compared PBRM outputs and evaluated cost-efficiency against FRM and UFAM.

Main Results:

• Centre case recruitment varied significantly (1 to 164 cases).
• Mean case reimbursements differed across cohorts and centres, often below expectations.
• PBRM demonstrated higher cost-efficiency than FRM and UFAM, particularly for centres with low recruitment.

Conclusions:

• A transparent, accurate, and flexible PBRM has been developed.
• PBRM is suitable for multi-centre collaborations with expected heterogeneity, addressing performance discrepancies effectively.