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Cochrane reviews need to cope with the flood tide of innovations

Date and Location

Session: 

P3.080

Date

Sunday 22 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

Olaf Weingart

Contact person

Olaf Weingart
Abstract text
Background: In Germany the reimbursement of new methods not covered by German DRG, is based on a yearly request by hospitals. An individual contract with health insurances is compulsory for covering additional costs. Requests by ten or more hospitals indicate the vast use in patient-centered care. To support the negotiations of health insurances, the Medical Advisory Service prepares evidence overviews assessing the health benefits and risks for patients. Objectives: To assess whether Cochrane reviews can support the needs of reimbursement controlled health systems. Methods: For new non pharmaceutical interventions ten or more hospitals requested in 2012 the Cochrane Library was scanned for titles, protocols and published reviews of these interventions. The number of RCTs was retrieved from the results of the evidence overviews prepared in 2012. Results: In 2012 more then 10 hospitals requested special reimbursement for 30 new interventions. For 9 of them, at least one RCT was published, but only 4 Cochrane protocols and 1 title addressed these topics (see table). There was no specific full Cochrane review for any topic. Conclusions: The introduction of new innovations is faster than the generation of evidence, which may result in risks for patients in reimbursement controlled health systems. It seems likley that the publication of Cochrane reviews is too slow to serve the preparation of evidence overviews. On the other hand, it would be of much help if Cochrane reviews would be published if no RCT is included. This will be the case often in early stages of innovation development. Addressing the lack of evidence and allowing clinical / scientific discussion, as well as identifying the need for further research, is of paramount importance for patient health and safety. The annually updated evidence overviews could even be useful for prioritizing Cochrane reviews, since these indicate the needs in patient-centered care.
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