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Ten years of German benefit assessment: price analysis for drugs with unproven additional benefit
- Katrin Kleining, Jan Laufenberg, Philip Thrun, Dorothee Ehlert, Jürgen Wasem, Arne Bartol
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- Journal:
- Health Economics, Policy and Law , First View
- Published online by Cambridge University Press:
- 14 August 2023, pp. 1-18
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Introduction
Since 2011, the prices for all new drugs in Germany are negotiated based on a benefit assessment. The purpose of this study was to analyze the price regulation of drugs with unproven additional benefit.
MethodsBenefit assessment procedures from 2011 to 2020 were reviewed and selected through AMNOG Monitor and Lauer Taxe. Negotiated annual therapy costs, the annual costs of the most cost-efficient appropriate comparative therapy (ACT) and the potential budget impact for 33 included procedures were calculated.
Results55% of the included drugs achieved a negotiated price higher than the most cost-efficient ACT, 3% were identified as equal and 42% showed lower negotiated prices. The potential savings exceeded expenditures by around EUR 523.5 m. After price flexibility was adopted by the legislator in 2017, the overall potential savings still outweighed the expenditures by around EUR 62 m.
ConclusionsOur analysis shows that making price negotiations more flexible by law does not undermine the fundamental aim of the AMNOG, which is to avoid additional expenditure without increased patient benefit. The regulation can thus fulfill the objective provided by the legislature of keeping drugs without proven additional benefits in the German healthcare system.
Chapter 9 - Writing the Land, Writing Relations: Kim Scott’sThat Deadman Dance
- Edited by Geoff Rodoreda, Eva Bischoff
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- Book:
- Mabo's Cultural Legacy
- Published by:
- Anthem Press
- Published online:
- 23 February 2022
- Print publication:
- 08 June 2021, pp 131-144
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Summary
In the Uluru Statement from the Heart, released on 26May 2017, a delegation of Aboriginal and TorresStrait Islander people calls for establishing a‘First Nations Voice’ in the Australian Constitutionand for a so-called Makarrata Commission tosupervise a process of ‘agreement-making’ and‘truth-telling’ (Referendum Council 2017, i). Intheir statement, they emphasise that Aboriginal andTorres Strait Islander people were the firstsovereign nations of the Australian continent andits adjacent islands. They substantiate this claimto sovereignty as follows:
This sovereignty is aspiritual notion: the ancestral tie between theland, or ‘mother nature’, and the Aboriginal andTorres Strait Islander peoples who were borntherefrom, remain attached thereto, and must oneday return thither to be united with ourancestors. This link is the basis of the ownershipof the soil, or better, of sovereignty.It has never been ceded or extinguished, andco-exists with the sovereignty of the Crown.(Referendum Council 2017, i; italics in theoriginal)
The part in italics explicitly links the UluruStatement to the Mabo judgement. Justice Brennanquotes these words from the Separate Opinion of VicePresident Ammoun, appended to the Advisory Opinionon Western Sahara, issued in 1975 by theInternational Court of Justice, to dismiss thenotion that a land can be terranullius (Mabo 1992, 40). The Uluru Statement canthus be read as a direct response to Mabo and thediscourse of Indigenous rights toself-determination, pointing out the continuingstruggle of Aboriginal and Torres Strait Islanderpeople for recognition of their sovereignty in theform of an unbroken interconnectedness with theland. In other words, this passage highlights whatMabo denied to admit in 1992, namely thatacknowledging relationality with the land cannot bedetached from a recognition of unceded Indigenoussovereignty.
In this chapter, I use the term ‘sovereignty’ in thesense of embodied relations with the land or, morebroadly speaking, an all-encompassing relationality.Such a definition follows the views of someAboriginal scholars and authors, such as AileenMoreton-Robinson and Kim Scott. Moreton-Robinson,for instance, argues that Indigenous sovereignty iscomposed of embodied relations rather than anabsolute, supreme authority, as ‘it is groundedwithin complex relations derived from theintersubstantiation of ancestral beings, humans andland’ (2007, 2).
Contributors
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- By Jane E. Adcock, Yahya Aghakhani, A. Anand, Eva Andermann, Frederick Andermann, Alexis Arzimanoglou, Sandrine Aubert, Nadia Bahi-Buisson, Carman Barba, Agatino Battaglia, Geneviève Bernard, Nadir E. Bharucha, Laurence A. Bindoff, William Bingaman, Francesca Bisulli, Thomas P. Bleck, Stewart G. Boyd, Andreas Brunklaus, Harry Bulstrode, Jorge G. Burneo, Laura Canafoglia, Laura Cantonetti, Roberto H. Caraballo, Fernando Cendes, Kevin E. Chapman, Patrick Chauvel, Richard F. M. Chin, H. T. Chong, Fahmida A. Chowdhury, Catherine J. Chu-Shore, Rolando Cimaz, Andrew J. Cole, Bernard Dan, Geoffrey Dean, Alessio De Ciantis, Fernando De Paolis, Rolando F. Del Maestro, Irissa M. Devine, Carlo Di Bonaventura, Concezio Di Rocco, Henry B. Dinsdale, Maria Alice Donati, François Dubeau, Michael Duchowny, Olivier Dulac, Monika Eisermann, Brent Elliott, Bernt A. Engelsen, Kevin Farrell, Natalio Fejerman, Rosalie E. Ferner, Silvana Franceschetti, Robert Friedlander, Antonio Gambardella, Hector H. Garcia, Serena Gasperini, Lorenzo Genitori, Gioia Gioi, Flavio Giordano, Leif Gjerstad, Daniel G. Glaze, Howard P. Goodkin, Sidney M. Gospe, Andrea Grassi, William P. Gray, Renzo Guerrini, Marie-Christine Guiot, William Harkness, Andrew G. Herzog, Linda Huh, Margaret J. Jackson, Thomas S. Jacques, Anna C. Jansen, Sigmund Jenssen, Michael R. Johnson, Dorothy Jones-Davis, Reetta Kälviäinen, Peter W. Kaplan, John F. Kerrigan, Autumn Marie Klein, Matthias Koepp, Edwin H. Kolodny, Kandan Kulandaivel, Ruben I. Kuzniecky, Ahmed Lary, Yolanda Lau, Anna-Elina Lehesjoki, Maria K. Lehtinen, Holger Lerche, Michael P. T. Lunn, Snezana Maljevic, Mark R. Manford, Carla Marini, Bindu Menon, Giulia Milioli, Eli M. Mizrahi, Manish Modi, Márcia Elisabete Morita, Manuel Murie-Fernandez, Vivek Nambiar, Lina Nashef, Vincent Navarro, Aidan Neligan, Ruth E. Nemire, Charles R. J. C. Newton, John O'Donavan, Hirokazu Oguni, Teiichi Onuma, Andre Palmini, Eleni Panagiotakaki, Pasquale Parisi, Elena Parrini, Liborio Parrino, Ignacio Pascual-Castroviejo, M. Scott Perry, Perrine Plouin, Charles E. Polkey, Suresh S. Pujar, Karthik Rajasekaran, R. Eugene Ramsey, Rahul Rathakrishnan, Roberta H. Raven, Guy M. Rémillard, David Rosenblatt, M. Elizabeth Ross, Abdulrahman Sabbagh, P. Satishchandra, Swati Sathe, Ingrid E. Scheffer, Philip A. Schwartzkroin, Rod C. Scott, Frédéric Sedel, Michelle J. Shapiro, Elliott H. Sherr, Michael Shevell, Simon D. Shorvon, Adrian M. Siegel, Gagandeep Singh, S. Sinha, Barbara Spacca, Waney Squier, Carl E. Stafstrom, Bernhard J. Steinhoff, Andrea Taddio, Gianpiero Tamburrini, C. T. Tan, Raymond Y. L. Tan, Erik Taubøll, Robert W. Teasell, Mario Giovanni Terzano, Federica Teutonico, Suzanne A. Tharin, Elizabeth A. Thiele, Pierre Thomas, Paolo Tinuper, Dorothée Kasteleijn-Nolst Trenité, Sumeet Vadera, Pierangelo Veggiotti, Jean-Pierre Vignal, J. M. Walshe, Elizabeth J. Waterhouse, David Watkins, Ruth E. Williams, Yue-Hua Zhang, Benjamin Zifkin, Sameer M. Zuberi
- Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
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- Book:
- The Causes of Epilepsy
- Published online:
- 05 March 2012
- Print publication:
- 14 April 2011, pp ix-xvi
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