[Managed care. Economic evaluation. Necessity, possibilities and limits]

The German health care sector is faced with significant structural problems. In addition to existing shortcomings, serious new problems are already on the horizon, and threaten to aggravate the discrepancy between reasonable medical needs and the resources available to finance them. The resolution of this problem requires the use of new tools capable of helping physicians make economically sensible choices. While economic evaluation methods can help point up the economic consequences of various therapies they do nothing more than aid the physician to make decisions, and cannot be allowed to relieve him/her of this responsibility. The principle that medical ethics take preference of economic considerations must remain in place.