Source: Henning Schacht
Matthias Borst, Chairman of the Board of the German Association of the Diagnostics Industry, lists the figures like a prayer wheel: Every year as many as 700,000 people die of antimicrobial resistance – each case also generates additional general public costs of €10,000. Antimicrobial resistance is a global problem. Three-quarters of medical practitioners worldwide have already experienced antibiotic failure. The reasons include excessive use in countries such as the USA, where antibiotics are taken like candy.
Politics lags behind
Borst stressed that resistance must be prevented at an early stage. The development of rapid testing is progressing, politics lags behind. Specifically, this is about the inclusion of new diagnostics in standard care in German statutory health insurance (GKV). The inclusion of new diagnostics, and thus their reimbursement via the Uniform Value Scale (EBM), must be faster and more transparent. According to Borst, doctors must have the certainty that their laboratory budget will not be overstretched by the use of tests. A lot of money is also involved in this issue, and the interests of the association that springs from the interests of its member companies must not be ignored.
Of course, Borst praises the German government’s initiative in 2015, for which it submitted its own antibiotic resistance strategy in DART 2020. The 20 most important industrialised and emerging countries had also put the topic on the agenda. The VDGH panel openly communicated that it was not a matter of defeating resistances, but merely ‘keeping them in check’ – it was a misconception that rapid tests could solve everything.
Unnecessary antibiotics prescriptions
Other worrying figures: Professor Klaus Heeg MD, Medical Director of the Department of Infectious Diseases, Microbiology and Hygiene at Heidelberg University Hospital, emphasised that, in Germany, ninety percent of antibiotics are prescribed by general practitioners (GPs) and only ten percent in hospitals – eighty to ninety percent of antibiotics are unnecessary. The bottom line is: costs to the general public and increasing resistance from mis-directed drugs. The problem is that many patients demand antibiotics from their physicians and the latter can hardly escape the pressure applied by the ‘customer’ patient.
This lies among the reasons why there is currently a project developed by the National Association of Statutory Health Insurance Physicians (KBV) and the Association of Health Insurance Funds (vdek). Intended to support prescribing physicians in out-patient care to provide a far more targeted treatment of acute respiratory tract infections, this project will receive a €14 million grant from the Innovation Fund. Results are expected to be presented in 2020. It remains to be hoped that this money will not trickle away again in the general formation of resistance.