Background: Drug provision within the German statutory health insurance system has undergone several reforms, including the introduction of drug macrobudgets in 1993.
Objective: The objective of this study was to investigate the extent to which statutorily (SHI) and fully privately (PHI) health-insured patients were provided with new medication recommended by professional bodies in an equitable fashion using the example of migraine patients.
Research Design: We conducted a retrospective cohort study.
Setting: A total of 367 primary-care practices (MediPlus, IMS Health) in Germany in the second year of the HealthCare Structural Reform Act were studied.
Subjects: Subjected consisted of 7703 SHI and 470 PHI migraineurs (International Classification of Diseases, 10th edition G43) aged 18 to 65 years at their first migraine prescription visit in 1994.
Outcome Measure: We compared prescription of oral or subcutaneous serotonin 5HT1B/1D receptor agonist sumatriptan with nonserotoninergic migraine therapy.
Results: In multiplicative risk regression with variance estimation accounting for clustering of patients within practices, PHI patients were 2.3 times (95% confidence interval [CI], 1.6-3.3) more likely to receive sumatriptan than their SHI counterparts at the mean age of the cohorts (43 years) adjusted for incident versus prevalent migraine treatment, the gender of the patient, the age, gender, and primary care specialist group of the physician, and the type and the community size class of the practice. This disparity widened by 38% (95% CI, 1-88%) every 10 years of patient age.
Conclusion: Even though virtually everyone in Germany has health insurance and drug coverage, use of new and recommended migraine medicines was less common among those with SHI compared with their privately insured counterparts. Systematic studies of access to health care recommended by professional bodies will be critically important to ensure delivery of high-quality health care for all patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/01.mlr.0000124265.13559.02 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Economic burden of Type 2 diabetes in Iran in 2022.
BMC Public Health
January 2025
Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Background: Diabetes mellitus, particularly Type 2 diabetes (T2D), represents a significant global health challenge, with its prevalence steadily rising over the past few decades. This study was conducted with the aim of estimating the economic burden of T2D in Iran.
Methods: This study employed a prevalence-based approach to estimate the economic burden of T2D and its attributable complications in adults above 20 years old in Iran for 2022.
Racial differences in clinical trial perceptions among a large, predominantly Black cohort of people with systemic lupus erythematosus in the Southeastern USA.
Lupus Sci Med
January 2025
Division of Rheumatology, Emory University, Atlanta, Georgia, USA.
Objective: Black people in the USA have a higher incidence and severity of SLE and worse outcomes, yet they are significantly under-represented in SLE clinical trials. We assessed racial differences in clinical trial perceptions among a large cohort of predominantly Black people with SLE.
Methods: Georgians Organised Against Lupus (GOAL) is a population-based, prospective cohort of people with a validated diagnosis of SLE living in Atlanta.
Classes of outpatient quality of care among individuals with substance-related disorders, based on a survey and health insurance registry.
J Subst Use Addict Treat
January 2025
Department of Psychiatry, McGill University, Douglas Hospital Research Center, Montreal, Quebec, Canada. Electronic address:
Objectives: Improving quality of care for individuals with substance-related disorders (SRD) should be a priority considering SRD are associated with high morbidity. This study aimed to identify classes of individuals with SRD based on their clinical characteristics and the quality of outpatient care they received, and to verify whether better quality of care was associated with other respondent characteristics and more favorable subsequent outcomes.
Methods: Data came from the 2023-14 and 2015-16 Canadian Community Health Survey (N = 42,099), merged with administrative data from Quebec's health insurance registry.
Barriers to early detection: Insurance denials for breast MRI screening in women with germline BRCA1/2 mutations.
Gynecol Oncol
January 2025
New York University Langone Health, Long Island, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Mineola, NY, United States of America. Electronic address:
Objectives: Women with germline BRCA1/2 pathogenic variants (gBRCA1/2) are recommended to undergo annual breast MRI and mammography. Our objective was to describe the frequency of insurance denials for annual breast MRIs in women with gBRCA1/2 and determine denial trends.
Methods: Women with gBRCA1/2 following in a high-risk breast cancer clinic with breast MRIs ordered from 2020 to 2021 were identified and cross-referenced with a database of insurance denials.
Cysteine-Specific F and NIR Dual Labeling of Peptides via Vinyltetrazine Bioorthogonal Conjugation for Molecular Imaging.
J Med Chem
January 2025
Department of Respiratory and Critical Care Medicine, Targeted Tracer Research and Development Laboratory, Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Key Laboratory of Sichuan Province & Precision Medicine Center, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital of Sichuan University, Chengdu 610041, China.
Radiolabeled peptides are vital for positron emission tomography (PET) imaging, yet the F-labeling peptides remain challenging due to harsh conditions and time-consuming premodification requirements. Herein, we developed a novel vinyltetrazine-mediated bioorthogonal approach for highly efficient F-radiolabeling of a native peptide under mild conditions. This approach enabled radiosynthesis of various tumor-targeting PET tracers, including targeting the neurofibromin receptor (), the integrin αβ (), and the platelet-derived growth factor receptor β (), with a radiochemical yield exceeding 90%.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!