Projects terminated

Individualized Health Care: Ethical, Economic and Legal Implications for the German Health Care System (ELSA funding programme)
Head/Team:Dr. W. Rogowski, Prof. Dr. R. Leidl, F. Severin
Funding:German Ministry of Education and Research, funding programme "Ethical, Legal and Social Aspects of Modern Life Sciences and Biotechnology" (ELSA), grant number 01GP1006B
Duration:2011-2013
Objectives:
  1. To analyze the ethical, health economic and legal challenges of individualized concepts of prevention and treatment, based on selected case studies.
  2. To develop ethically and legally justified and economically viable solutions for administering and allocating individualized health care, especially as it relates to economic evaluation and prioritization. 
Outline:Due to genetic and physiological variation, patients differ in their health risks, chances for curative treatment and reactions to specific drugs. In the future, it is expected that the prevention and treatment of diseases will be tailored more specifically to individual patients or patient groups. Decision-makers hope that this individualized approach will improve the quality and efficiency of health care.

The current interdisciplinary project will consider problems related to  individualized health care from an ethical and legal as well as economic perspective, and the health economic analysis will be carried out at our institute. Against the background of scarce health care resources, decision analytic cost-effectiveness studies of particular applications of individualized medicine will be conducted.

Distinctive methodological problems arise in the evaluation of individualized health care services. For example, data availability is often limited due to small sample sizes. Moreover, there is often a lack of evidence on the clinical utility of new medical technologies, such as pharmacogenetic tests or genetic screening programmes. Besides the evaluation of costs and benefits of new technologies, value-of-information analysis therefore plays an important role. With this methodology, the value of further research to improve the knowledge basis for technology adoption decisions will be analyzed.

A central aim of the project is to identify key methodological, ethical and legal challenges in the evaluation process. Based on the health economic case studies, the project partners will analyze how ethically and legally justified and economically rational priorities can be set in the context of introducing individualized medicine within the German health care system. With this approach, taking into account ethical and legal considerations as a complement to sound economic evaluation, we want to contribute to the discussion on the future of individualized health care.