Publications by authors named "Florian Kron"

Introduction: Treatment with chimeric antigen receptor T (CAR-T) cells involves a large number of interdisciplinary stakeholders and is associated with complex processes ranging from patient-specific production to follow-up care. Due to the complexity, maximum process optimization is required in order to avoid efficiency losses. This study aimed at systematically determining the preconditions for a frictionless flow of the CAR-T process by surveying the stakeholders involved.

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Purpose: Next-generation sequencing (NGS) tools have clinical advantages over blood culture but are more expensive. This study assesses the budget impact and break-even point of NGS testing costs from a healthcare provider's perspective in Germany.

Methods: The budget impact was calculated based on aggregated data of German post-operative surgery cases.

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Introduction: Despite antifungal advancements, candidaemia still has a high mortality rate of up to 40%. The ECMM Candida III study in Europe investigated the changing epidemiology and outcomes of candidaemia for better understanding and management of these infections.

Methods: In this observational cohort study, participating hospitals enrolled the first ten consecutive adults with blood culture-proven candidemia.

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Objectives: Novel interventions (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel], tafasitamab-lenalidomide [Tafa-L], polatuzumab-rituximab-bendamustine [pola-BR]) improve clinical outcomes in second-line (2 L) treatment of transplant-ineligible patients with early relapse or refractory (R/R) diffuse large B cell lymphoma (DLBCL). The costs vary depending on the respective treatment regimen and the treatment duration, difficult comparability in reimbursement decisions. The objective was to analyze the health economic impacts of novel 2 L interventions and conventional immunochemotherapies (bendamustine-rituximab [BR], rituximab-gemcitabine-oxaliplatin [R-GemOx]) from a German healthcare payer's perspective as a function of treatment duration.

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Article Synopsis
  • CDI, caused by Clostridioides difficile, leads to healthcare-associated diarrhea, and fidaxomicin (FDX) is suggested to be more effective and cost-efficient than vancomycin (VAN) for treatment.
  • The study analyzed data from University Hospital Cologne, focusing on the costs and recurrence rates of CDI for both treatments, and found total average costs of €32,901 for non-recurrent cases and €10,952 for recurrent cases.
  • The budget impact analysis revealed a potential cost savings of €1,303 favoring FDX over VAN, highlighting the need for future research on treating specific groups like refractory CDI patients.
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  • Triple-negative breast cancer (TNBC) accounts for 10-20% of breast cancer cases, leading to increased healthcare costs that necessitate health-economic evaluations to assess treatment options.
  • The research analyzed the cost-benefit ratio of approved TNBC treatments in Germany using an efficiency frontier approach, focusing on costs and clinical benefits like median overall survival (mOS) and health-related quality of life (HRQoL).
  • Findings showed that vinorelbine is the most cost-effective treatment, followed by sacituzumab-govitecan, with specific data on treatment costs and overall survival metrics reported for each therapy, guiding healthcare decision-makers in treatment choices.
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Objective: This study aimed to assess the budget impact of vacuum-induced hemorrhage control (VHC) devices for treating postpartum hemorrhage (PPH) from the perspective of the German statutory health insurance (SHI).

Study Design: Evidence shows that treating PPH with VHC instead of uterine balloon tamponade (UBT) can reduce resource consumption (e.g.

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  • The study evaluates the cost-effectiveness of various treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) from a German healthcare payer's perspective, particularly focusing on the economic impact of recently approved therapies.
  • A systematic literature review was conducted to assess median overall survival and first-year treatment costs for various treatment options, including CAR-T therapies and targeted therapies.
  • The findings reveal specific cost-effectiveness thresholds for both second-line and third-line treatments, assisting in guiding reimbursement decisions internationally.
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  • The study analyzes the economic implications of using pathogen inactivation (PI) platelet concentrates (PCs) compared to conventional PCs in Germany's healthcare system.
  • It examines inpatient treatment costs based on real-life data from 951 cancer cases at University Hospital Cologne, focusing on factors such as reimbursement rates, length of stay, and resource usage.
  • The findings suggest that hospitals could save between EUR 184 and EUR 306 per case by opting for PI-PCs, highlighting a positive economic impact despite the initial investment needed for PI implementation.
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  • The study evaluates the costs of different invasive treatments for pleural effusions and ascites, revealing the significant financial disparity between inpatient and outpatient options.
  • Outpatient puncture is the cheapest treatment for both conditions, costing €60.02 for ascites and €70.03 for pleural effusions, while inpatient treatments can exceed €8,867.84.
  • The use of indwelling catheter systems (ICSs) not only improves patient quality of life for prolonged periods but also presents a potential for cost savings.
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Objective: species are responsible for fungal diseases and the development of nosocomial bloodstream infections. Treatment is resource-intensive and economically challenging for healthcare systems. Cost analyses of drugs against candidiasis, such as rezafungin, are thus of great interest to healthcare payers.

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Background: The treatment of acute bacterial skin and skin structure infections (ABSSSI) usually involves intravenous (i.v.) antibiotics requiring hospitalisation and increasing hospital costs.

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Background: Invasive fungal diseases (IFD) are life-threatening and demand timely and appropriate treatment. Research showed that isavuconazole treatment positively affects clinical outcome and length of hospital stay (LOS).

Objectives: The aim of this study was to assess the hospital costs of patients diagnosed with IFD and treated with isavuconazole using real-world data from a German cancer centre.

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Multidrug-resistant Gram-negative bacteria (MDR-GNB) cause serious infections and aggravate disease progression. Last resort antibiotics are effective against MDR-GNB and are reimbursed by flat rates based on German diagnosis-related groups (G-DRG). From a hospital management perspective, this analysis compared hospital reimbursement for last resort antibiotics with their acquisition costs to outline potential funding gaps.

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Background: In the past decades, highly innovative treatments in the field of diffuse large B-cell lymphoma (DLBCL) became available in clinical practice. The aim of this study was to assess the cost-benefit relation of third-line interventions in DLBCL from a German payer perspective.

Methods: Clinical benefit of allogeneic stem cell transplantation (alloSCT), chimeric antigen receptor T cells therapy (CAR T) [tisagenlecleucel (tisa-cel) and axicabtagene ciloleucel (axi-cel)] and best supportive care (BSC) was assessed in terms of median overall survival (median OS) derived from a systematic literature review in PubMed.

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Objectives: Internationally, healthcare systems are confronted by an ever-increasing scarcity of medical resources due to the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate the impact of remdesivir on the demand of hospital bed capacities for hospitalized COVID-19 patients and to evaluate the potentially created capacities for treating additional COVID-19 patients or elective treatments at the hospital.

Methods: An epidemiological model was developed that utilized the population of Cologne (Germany) during the first COVID-19 wave (first hospitalized patient-30 September 2020) to compare two scenarios: no administration of remdesivir (A) and the administration of remdesivir according to the EMA label (B).

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Article Synopsis
  • Clostridioides difficile infection (CDI) is a major hospital-related infection that leads to longer hospital stays and higher costs, with bezlotoxumab being an effective preventive monoclonal antibody.
  • A budget impact analysis compared the costs of standard care (SoC) with SoC plus bezlotoxumab for high-risk CDI patients, examining different scenarios regarding hospital readmissions.
  • Results indicate that using SoC plus bezlotoxumab is cost-saving for hospitals due to shorter patient stays, but hospitals need to negotiate additional fees to cover bezlotoxumab administration.
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Purpose: First detected in China in 2019, the novel coronavirus disease (COVID-19) has rapidly spread globally. Since then, healthcare systems are exposed to major challenges due to scarce personnel and financial resources. Therefore, this analysis intended to examine treatment costs of COVID-19 inpatients in a German single centre during the first pandemic wave in 2020 from a healthcare payer perspective.

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Background: Kron et al (Mycoses, 64, 2021, 86) found cost savings for the use of the innovative pharmaceutical isavuconazole in the inpatient setting in Germany (Bismarck-based healthcare system). Little is known about the reimbursement of innovative pharmaceuticals in the inpatient setting of Beveridge-based healthcare systems.

Objectives: The aim of this study was to evaluate the market access process and reimbursement of isavuconazole, exemplary for innovative pharmaceuticals, in England and Spain.

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Introduction: Robust data on the outcome of MET-aberrant NSCLC with nontargeted therapies are limited, especially in consideration of the heterogeneity of MET-amplified tumors (METamp).

Methods: A total of 337 tumor specimens of patients with MET-altered Union for International Cancer Control stage IIIB/IV NSCLC were analyzed using next-generation sequencing, fluorescence in situ hybridization, and immunohistochemistry. The evaluation focused on the type of MET aberration, co-occurring mutations, programmed death-ligand 1 expression, and overall survival (OS).

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Background: Isavuconazole (ISA) is a frequently used antifungal agent for the treatment of invasive fungal diseases (IFDs). However, hospital reimbursement data for ISA is limited.

Objectives: The primary objective of this study was to analyse the different perspectives of relevant stakeholders and the (dis)incentives for the administration of ISA in Germany.

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Introduction: The treatment of cancer patients in Germany is characterized by sectoral separation of the in- and outpatient care accompanied by 2 separate reimbursement systems. By introducing the Guideline of Outpatient Medical Specialist Care in accordance with §116b SGB V (ASV) in 2014, the German legislation empowers office-based physicians and hospitals to jointly provide medical care in the ambulatory setting.

Methods: A 1-year period each before and after the introduction of ASV was compared by means of data from the Center for Integrated Oncology Cologne at the University Hospital of Cologne.

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Article Synopsis
  • The increasing costs of innovative cancer treatments necessitate new financing solutions to ease the burden on healthcare systems.
  • The study analyzed the potential health-economic impact of biosimilars, focusing on trastuzumab, rituximab, and G-CSF in the German healthcare system.
  • Results show that adopting biosimilars could lead to significant annual savings, potentially freeing up resources to fund new treatments.
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Objectives: Mucormycosis is a difficult-to-diagnose life-threatening disease with high morbidity and mortality. Adherence to guidelines that lead through complex management and support clinical decisions is however rarely reported. By applying the EQUAL Score, our study evaluates the management of mucormycosis at the University Hospital of Cologne, Germany.

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Background: Complications after surgery for esophageal cancer are associated with significant resource utilization. The aim of this study was to analyze the economic burden of two frequently used endoscopic treatments for anastomotic leak management after esophageal surgery: Treatment with a Self-expanding Metal Stent (SEMS) and Endoscopic Vacuum Therapy (EVT).

Materials And Methods: Between January 2012 and December 2016, we identified 60 German-Diagnosis Related Group (G-DRG) cases of patients who received a SEMS and / or EVT for esophageal anastomotic leaks.

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