Where does Germany's aversion to cost-benefit assessments in health care come from?

It is widely assumed that in Germany it is particularly difficult to address the issue of the relationship between costs and benefits in medicine. It is argued that the reception of recent medical historiography makes it possible to more clearly identify a specifically German tradition of questionin...

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Bibliographic Details
Published in:Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen Fortbildung und Qualität im Gesundheitswesen, 2022-05, Vol.170, p.38
Main Author: Schmacke, Norbert
Format: Article
Language:ger
Subjects:
Cost-Benefit Analysis
Delivery of Health Care
Germany
Humans
Prospective Studies
Online Access:Get full text
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Summary:It is widely assumed that in Germany it is particularly difficult to address the issue of the relationship between costs and benefits in medicine. It is argued that the reception of recent medical historiography makes it possible to more clearly identify a specifically German tradition of questioning theory-based controlled comparisons of clinical efficacy. Of central importance here is the Comparative Therapy (Vergleichende Therapie - V.T.) project carried out during the Second World War, whose guiding spirit was Paul Martini (1889-1964). The failure of this large-scale project influenced the further development of the methodology of clinical research and contributed to the "lateness" of the acceptance in Germany of prospective controlled clinical trials compared to the Anglo-American world. This also needs to be viewed in combination with the deep scepticism towards the cost-benefit debate whose rationale is still frequently questioned in Germany in relation to the need for individualised medicine. It seems important to give medical historiography greater space in order to reach a better understanding of the culture of the "late EbM nation Germany".
ISSN:2212-0289