BMJ  2004;329:307 (7 August), doi:10.1136/bmj.329.7461.307-a

News

Germany sets up quality control institute for health care

Heidelberg

Germany's federal joint committee of doctors, health insurance companies, and patients (the Gemeinsame Bundesausschuss) has announced the foundation of a new, independent Institute for Quality and Economic Efficiency in Health Care—Germany's equivalent of England's National Institute for Clinical Excellence.

The main task of the new institute, which has a staff of about 30, is to research the latest medical knowledge on diagnostics and therapy of selected diseases and provide expertise on quality and economic efficiency.

The institute will also evaluate the evidence based guidelines of the most common diseases and prepare recommendations for setting up disease management programmes. In addition, the institute will evaluate the effectiveness of drug treatment and prepare information about the quality and efficiency of health care for the public.

Its first director is Professor Peter Sawicki, a physician and diabetes specialist who founded a private research institute, the Institute for Evidence-Based Medicine, in 2002 ( BMJ 2004;328: 485[Free Full Text]).

The establishment of the Institute for Quality and Economic Efficiency in Health Care has already been criticised by doctors and the pharmaceutical industry. Doctors fear that they will be confronted with "cookery book medicine" and "patronising state medicine," which will abolish every chance of giving individual treatment. They welcome, however, more scientifically based advice on effective drug treatment. The drug industry is sceptical of yet another bureaucratic obstacle to the introduction of innovative drug treatment.

Professor Sawicki says that innovations are not necessarily always beneficial and have to be scientifically evaluated for their clinical and economic benefits. But he accepts that independent evaluation should be carried out immediately after a drug's approval.

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