Health Economist Questions IQWiG's Methods

Professor Oliver Schöffski, head of Health Management at the University of Erlangen-Nuremberg, has raised concerns regarding the methodologies employed by the German Institute for Quality and Efficiency in Health Care (IQWiG) in assessing the value of new pharmaceuticals.

Schöffski's critique focuses on IQWiG's approach to early benefit assessments under Germany's AMNOG law, which influences price negotiations. He contends that the current methods, which primarily consider the perspective of statutory health insurance (GKV), are too narrow. This perspective tends to focus solely on direct medical costs, overlooking wider economic impacts.

"From an economic viewpoint, this is insufficient. A broader societal perspective should be taken," Schöffski stated. He highlighted that improved health outcomes can lead to reduced absenteeism from work, thereby decreasing productivity losses for the economy.

Furthermore, Schöffski pointed out that IQWiG's methodology does not facilitate comparisons across different therapeutic areas or disease categories. This limitation hinders the efficient allocation of resources within the healthcare system. In contrast, countries like the UK utilize unified benefit measures that integrate various factors, such as quality of life and life expectancy, allowing for broader efficiency comparisons.

Schöffski also questioned the sequential nature of IQWiG's assessment process. The institute first conducts an early benefit assessment, followed by an optional cost-effectiveness evaluation. He suggested this two-step approach might disadvantage innovations that offer marginal benefits but are significantly more cost-effective, failing to recognize their economic efficiency.