Doctors are concerned

Expensive drugs: board has been rushed through

The use of expensive drugs is to be controlled by a separate committee

(Bild: DenisIsmagilov, stock.adobe.com / KroneMED)

The controversial medication evaluation board, which is intended to regulate uniform access to particularly expensive medications in hospitals, will soon become a reality. However, no consideration was given to the concerns of patient representatives and criticism from health experts and doctors. The board will remain unchanged, as can be seen from the rules of procedure available to the "Krone".

The basic idea of the board is welcomed by experts. The idea is that special, particularly expensive medicines and therapies (e.g. 200,000 euros per patient) are coordinated and purchased uniformly for hospitals. At present, each hospital buys for itself and negotiates with the pharmaceutical industry. The contracts are often secret. This new committee is to be created not least in order to save costs for the system.

Too few experts on the committee
However, there is massive criticism of its composition. Of the 24 voting members, only 3 are independent representatives of the scientific community. The only patient representative has no voting rights. Most of the committee members are delegated by authorities and "payers", such as the Ministry of Health, the Federal Office for Safety in Health Care, the federal states and social insurance companies.

No personal access to external advisors
In the event that external experts are called in, the office should only "provide the board members with the necessary information". The members of the Board are de facto denied access to the information value of external experts because no personal consultation is possible.

Hospitals are currently buying their medicines on their own

(Bild: zVg)

Months of delays feared
One of the biggest points of criticism is the feared time delay. In principle, therapies should only be used once they have been evaluated by the panel. Five months are planned for the evaluation by the assessment board, with the possibility of extending the deadline to a total of eight months. Critics see this as an unreasonable delay that could have fatal consequences for patients' lives.

Economic efficiency before medical necessity
Although many experts welcome the standardization of medication dispensing within Austria, they see the Board as focusing on economic efficiency rather than medical necessity. The rules of procedure prescribe the economization of the medical benefit of a therapy and thus contradict the legally guaranteed level of treatment in accordance with the current state of medical and pharmaceutical science.

Legal concerns raised
Many experts have constitutional concerns here. Specifically, this concerns drugs that cost more than 50,000 euros per pack or monthly treatment costs of 20,000 euros or annual treatment costs of more than 200,000 euros. Health Minister Johannes Rauch has so far not listened to the experts' concerns. He argues that the board will above all create more transparency.

Until now, each hospital has conducted its own negotiations with the pharmaceutical companies, which have also been completely non-transparent. In addition, only expert representatives from the fields of human medicine and pharmacy would sit on the board, which could only make recommendations. The final decision regarding the medicinal products remains with the treating doctor or hospital. Next Friday, the rules of procedure of the evaluation board will be approved in the so-called target steering group between the federal and state governments.