EHCM / Empirical Health Care Management

The ECHM project studies the role of innovation and regulation in health care markets and the related market reactions by health care providers. We aim to provide evidence to the following research questions: 

  • What is the impact of regulation on provider behavior in terms of technology diffusion and health care utilization?
  • Why are the most efficient technologies not used by health care systems?

We rely on empirical analyses using administrative or market research data and, survey based analyses. Study results contribute to a better understanding of market reactions from innovation and regulation in health care markets from the perspective of health policy and health care management.

Ongoing:

Drug shortages: consequences for cost and quality of care

Drug shortage is a growing problem in many health systems with potential negative effects on the health of patients affected.  This project investigates for Switzerland the impact of drug shortages on the prescription behaviour of physicians and its impact on the quality and cost of treatment in the years 2016 to 2019.

Collaborating Institution: University of Basel

InnoZert: Innovative capacity and certification in specialized health care – Organ cancer centers in Germany

This project aims at analyzing the relationships between innovative capacity and standardization of specialized health care providers. Specifically, we examine the potential trade-offs between building capacities for innovation and quality control through standardization. In 2003, the first certification program for organ cancer centers was implemented, aiming at the improvement of health care for cancer patients through quality certificates. At the same time, cancer care is constantly changing with new diagnosis and treatment methods resulting from the innovative capacity of hospitals and manufacturers of health technologies. Up to date, the relation between innovative capacity of specialized health care providers and their standardization through certification remains ambiguous. We will analyze variation in innovative capacity and standardization at organizational and regional level and over time in selected groups of organ cancer centers as well as the relationship of these measures with treatment outcomes.

Collaborating and funding Institution: Deutsche Krebsgesellschaft (German Cancer Society)

Completed:

The impact of biomedical innovation on medication non-adherence

Medication non-adherence has been identified as substantial source of waste across health care systems. In this project, we study the influence of pharmaceutical innovation on adherence behavior in the working population in Germany and the United States. We focus on analyses of chronic conditions using real world data on drug utilization.

Collaborating institution: Columbia Business School, Columbia University, DocMorris

Utilization and adoption of pharmaceuticals by physicians of ambulatory care

Physicians are typically faced with a multitude of influences when making choices to prescribe pharmaceuticals to patients. In this project, we study the role of information and regulation on utilization and adoption of health technology products. We account for different product types (e.g., new products, biosimilars, generics). We use econometric analyses to study the effects of varying information signals (reimbursement decisions) and the role of regulation (e.g., quotas, budgets) at different levels of the health care system.

Collaborating institutions: King's College London, Hamburg Center for health Economics

The impact of regulation at the regional level using the example of biosimilars

In 2006, the first biosimilar entered the German market. Today, the utilization rate of biosimilars varies largely across regions. Reason for the differing pace of diffusion and utilization could be divergent incentives to control health care spending, such as quotas or priority prescription regulations at regional level. In this project, we analyse the influence of meso-level regulation on physician prescribing behavior, which is part of the 2016 health services research initiative of the Central Research Institute of Ambulatory Health Care in Germany (Zi).

Collaborating and funding institution: Zentralinstitut für die Kassenärztliche Versorgung in Deutschland (Central Research Institute of Ambulatory Health Care in Germany (Zi))

Early benefit assessment of innovative pharmaceuticals according to AMNOG in Germany: empirical analysis of the decision-making process

By introducing the Act on the Reform of the Market for Medicinal Products (Arzneimittelmarktneuordnungsgesetz) in 2010, the regulatory framework for pharmaceuticals has changed for Germany. Manufacturers need to demonstrate a product’s health benefit and must negotiate prices accordingly. We aim to identify factors that determine the decision on added health benefit and prices. We differentiate between the quality of evidence, its presentation, technological characteristics, and process related aspects. We use a database of decisions and perform econometric analyses.

Collaborating institution: Hamburg Center for Health Economics, University of Hamburg