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Information on press releases and related news of the department "Health, Long‐Term Care and Pensions".

Authors from the SOCIUM Research Center on Inequality and Social Policy at the University of Bremen present the BARMER Long-Term Care Report for 2019

This year's BARMER Long-Term Care Report was presented today at the Conference Centre of the Federal Press Conference House in Berlin. The analysis of new living arrangements with long-term care provision is the central focus of this year’s Report. It also includes a review of LTC insurance 25 years since its inception. As in previous years, the authors – Professor Dr. Heinz Rothgang and Dr. Rolf Müller – continue to deliver in-depth analyses of case numbers, incidences, prevalences and long-term care trajectories. The data used for the Report are primarily long-term care statistics for the year 2017 and claims data provided by the health insurance fund BARMER.

Downloads:
BARMER Long-Term Care Report 2019 (in German)
Statement prepared by Professor Rothgang for the Press Conference
Presentation given by Professor Rothgang at the Press Conference


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Dr. rer. pol. Rolf Müller
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58554
E-Mail: rmint@uni-bremen.de

Cover Innovationsreport 2019Cover Innovationsreport 2019
Study on innovative medicines of the year 2016 in day to day care

This year's Innovation Report rates 21 active ingredients of the total of 31 medicines launched in 2016.

Oncologics were most frequently evaluated, five drugs contain antiviral drugs, three are recombinant coagulation factors. The remaining active ingredients cover eight further indications. For the first time, a vaccine (the HPV vaccine, which i.a. protects against cervical cancer) was rated in this report. Eight medicines were launched with a fast track assessment.

The special chapter of the report is dedicated to the current topic "vaccination and compulsory vaccination" and discusses measles, HPV and flu vaccines in particular.

The data of the RKI, the KiGGS study and the WHO state that the measles vaccination rates have still not been reached. They show that compulsory vaccination, which has already been introduced in some European countries, has not eliminated measles. The Innovation Report 2019 presents various approaches how an increase in vaccination rates could succeed and how the potential arguments of the anti-vaxxers could be. It illustrates the great importance of physician-patient communication in this context. Compulsory measles vaccination should be the ultima ratio - education and information campaigns need to be developed and strengthened in the public.

Although five medicines were rated with a green overall traffic light, the increase in red traffic lights (61% of all assessed medicines) has degraded the hope of a positive development of newly licensed medicines compared to the last year. For six medicines red hand letters with important information for physicians and patients were sent. This also confirms the assumption that current approval studies provide only a limited picture of effects and side effects, therefore pharmacovigilance studies in the "aftermarket" are urgently needed.

Medicines that represent a true therapeutic innovation and have been assessed with a green (added) benefit signal are human papillomavirus vaccines and medicines in cancer treatment of multiple myeloma (Daratumumab and Elotuzumab) and in the treatment of chronic heart failure with reduced ejection fraction (Sacubitril/Valsartan). Only one medicine (Elbasvir/Grazoprevir) is cheaper than the ACT and has been given a green light in this category. Regarding the price twelve medicines were rated as equally expensive (marked with a yellow traffic light) and four medicines as more expensive (marked with a red traffic light). In comparison with already available therapies, five medicines are marked in green, four in yellow, and 14 in red. Thus, only nine of the new medicines on the market contribute to already approved pharmaceuticals in a positive way.

 

Innovation Report 2019:

long version

short version

Presentation of Prof. Dr. Gerd Glaeske


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Thomas Kalwitzki at an Expert Hearing of the Committee on Health Care of the German Federal Parliament

On 8 May 2019 the Committee on Health Care of the German Federal Parliament (Deutscher Bundestag) organized a hearing attended by 17 experts and representatives of interest groups. The subject were the motions of the Green Party, the Left Party and the Free Democratic Party on a reform of the financing of the nursing care insurance. Heinz Rothgang had written an expert opinion on the issue and Thomas Kalwitzki answered questions at the hearing itself.

Rothgang and Kalwitzki point to a significant amount of unfairness between the two branches of the statutory nursing care insurance: the private obligatory nursing care insurance and the public nursing care insurance. This effects an unequal burden of financing the insurance for the different memberships of the two branches. Since the privately insured members on average include both the lower risks as well as the higher incomes the premiums covering the costs would be only one fourth of the premiums in the public insurance. Privately insured members are, hence, considerably less financially burdened than publicly insured members. This, however, contradicts the judgement of the German Federal Constitutional Court which called for a balanced burden-sharing between the two branches of the nursing care insurance for the people.

In order to distribute the financial burden fairly Rothgang and Kalwitzki advocated the introduction of a so called Citizen Nursing Care Insurance. It not only integrates the two existing branches of insurance but also adds additional forms of income (for example rental revenues or profits from interest) to the roster of incomes from which compulsory insurance premiums have to be deducted. And it increases the assessment ceiling up to which premiums have to be deduced. This will lead to a financial relief for the members of the public insurance branch and for the low-income members of the private insurance branch.

Rothgang and Kalwitzki also pointed to the fact that such a citizen insurance system can be implemented more easily in the realm of nursing care than for example in the realm of the normal health care system. Both the private as well as the public branches of the nursing care insurance are already based on similar regulations concerning services and service delivery. This reduces greatly possible resistance and implementation problems compared for example to the health insurance system.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Longer Better Living.-InstituteLonger Better Living.-Institute
Topical Issues and Renowned Speakers Guarantee Gerd Glaeske and the BKK24 a Full Audience

How can we motivate people of different social backgrounds to change their life style, their fitness behavior and their eating habits in order to live a healthier, longer and more satisfying life? The Second Congress for “A Longer Better Life” offers an interesting program put together by Professor Gerd Glaeske of SOCIUM and the BKK24. The congress will commence on May 14th, 2019 at the Adademie des Sports in Hanover. Since it is still the social background which determines the life expectancy the congress aims at exploring the possibilities to improve the individual motivation. The topical question guaranteed that the congress was fully booked in short time.

The Congress for “A Longer Better Life” is part of the preventive work of the Institute for “A Longer Better Life” which organized by the SOCIUM together with the BKK24.

More information: Longer Better Living.-Institute


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Professor Heinz RothgangProfessor Heinz Rothgang
Policy brief by Heinz Rothgang for the State Parliament of Schleswig-Holstein

After Hamburg offered its public officials an allowance for the membership in the public health insurance other states in German also discuss that option. Among them is Schleswig-Holstein. Heinz Rothgang, Professor of Health Economics at SOCIUM, wrote a policy brief for a hearing on this issue in Schleswig-Holstein.

In his policy brief Rothgang underlines four elements: Such a policy increases the choice of the public officials. It also strengthens the solidarity in the health care system, since it brings better risks back into the public system. Furthermore, such a policy reduces the administrative overhead since in the current system two bills for each case have to be processed. And this policy saves public expenditures in the long run since the higher costs of health care for elder people are then fully carried by the insurance system.

Rothgang, thus, supports the proposed policy but wants it based on two principles: First, it has to be voluntary for the public officials. And second the decision, once made, should not be revocable in order to avoid the typical double free-riding: to opt for the cheaper private insurance in younger years and then, when the costs rise in later years, to move to the public system.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Prof. Dr. Heinz RothgangProf. Dr. Heinz Rothgang
Heinz Rothgang member of the Scientific Advisory Board of the German Center of Gerontology.

One of the mostly overlooked benefits of research centers at universities is their ability to consult and advise political or politics-related institutions. Via this consultation recent research finds its way directly into policy making or administration. Heinz Rothgang, Professor of Health Economics at SOCIUM, recently was appointed member of the Scientific Advisory Board of the German Center of Gerontology for the next four years.

The German Center of Gerontology is one of the so called Ressortforschungseinrichtungen (ministerial research facilities) of the federal government and is part of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. It focuses on three core activities: collection and public dissemination of important data on demography and gerontology, research on gerontological questions and especially consulting of the Ministry and the Federal Government on demographical change and policies concerning senior citizens. This entails a broad spectrum of issues from work and pension, health, care, family situations, social relations as well as social participation of senior citizens.

The Scientific Advisory Board of the German center of Gerontology consists of nine professors mostly from social scientific faculties. They consult the Center and participate in guiding its research.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Cover Cover "Longer better living."-Book (in German)
Prevention recommendations implemented in everyday life.

The EPIC study, a long-term 13-year study of 20,000 participants in Norfolk, which showed the positive effects of four different health behaviors, forms the basis of this publication. Sufficient exercise, abstinence from smoking, five servings of vegetables and fruit per day, and limited alcohol consumption resulted in a life-time gain of up to 14 years. In order to facilitate the implementation of these rules in everyday life instructions, tips and evidence-based expert advice have been compiled here (in German).

Prof. Dr. Gerd Glaeske and Friederike Höfel from the "Longer better living."-Institute, which is dedicated to the implementation of these prevention goals, published this book together with Friedrich Schütte and Jörg Nielaczny of the BKK24.

More information about publication: Glaeske, Gerd; Höfel, Friederike; Schütte, Friedrich; Nielaczny, Jörg (Ed.), 2019: "Länger besser leben." Für eine bessere Gesundheit und mehr Wohlbefinden, "Länger besser leben."-Institut, BKK24, Bremen, Obernkirchen: Selbstverlag


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Dipl.-Soz. Friederike Höfel
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58520
E-Mail: fhoefel@uni-bremen.de

Cover Long-Term Care ReportCover Long-Term Care Report
Authors from the SOCIUM Research Center on Inequality and Social Policy, University of Bremen, presents BARMER Long-Term Care Report 2018.

This year’s BARMER Long-Term Care Report was presented today at the Conference Centre of the Federal Press Conference Building. Its main focus this year lay on the pressures and health status of principal caregivers; but the Report also examined the effects of the most recent long-term care reforms on the provision of long-term care. The authors, Professor Dr. Heinz Rothgang and Dr. Rolf Müller, also made in-depth evaluations of case numbers, incidences, prevalences and care trajectories. The primary data basis comprised long-term care statistics for 2015, routine data provided by the BARMER and a survey of 1,862 BARMER insurees conducted especially for this Report.

Care Grades instead of Care Levels Led to Increase in the Number of People Receiving Long-Term Care Benefits

The switch from care levels to care grades as of 1 January 2017 brought with it changes in the criteria determining rights of access to insurance benefits. Cognitive disabilities are now defined as a constituent of the eligibility rulesfor  insurance benefits, and respective access barriers have been reduced. The switch from care levels to care grades has also led to a significant increase in favourable assessments. According to projections based on BARMER figures, the number of long-term care dependents increased by 17.9 % between 2015 and 2017. Around 13 percentage points are attributable to the increase in Care Levels 1 and 2.

Broadened Entitlements mean Higher Costs

The increased social long-term care insurance expenditure resulting from the reform amounted to around 7 billion Euros in 2017. On the other hand, additional revenues from the reform amounted to 2.8 billion Euros, leaving a reform-related deficit of 4.2 bn. Thanks to the prior revenue surplus and income growth, however, the actual deficit in 2017 only amounted to 2.4 bn. Euros.

Most Long-Term Care Dependents are Cared for by Relatives

In December 2017, about 2.5 m. people in need of care were cared for by a principal caregiver. Two thirds of these principal caregivers were women, one third were men. Only one third of the principal caregivers taking part in the BARMER survey in 2018 were in gainful employment. A quarter, however, stated that they had reduced their hours or given up gainful employment completely to provide care.

Formal and Informal Support is often Inadequate

As a rule, the principal caregiver has to carry out numerous tasks (e.g. apply medication, give assistance at mealtimes, give mobility support or toilet assistance). Six out of ten principal caregives would like further support in at least one of eleven areas of responsibility. In addition to this general deficit, there are problems when it comes to finding substitutes. Significantly more than half of respondents have no opportunity to find anyone who will stand in for them when they need a break.

Frequently, caregivers do not avail of services offered because they are too expensive or suspected of being poor quality, because there are no services available, or because the organisational effort is too high. It becomes apparent that the needs of caregivers cannot be fulfilled because of the structure of the services offered or because they require too much effort. This is the case for around 378,000 principal caregivers (15.3 %) in daycare, 188,000 (7.6 %) in care services, 437,000 (17.7 %) in short-term care and 379,000 principal caregivers (15.3 %) in low-threshold care and domestic help.

Principal Caregivers are Often Subject to Greater Stress and Fall Ill More Frequently

In terms of coping, 87.5% of principal caregivers claim that they can cope most or all of the time. Nevertheless, a large percentage (38.0 %) do not get enough sleep; 29.9% feel trapped in their role as principal caregiver; one in five (20.4 %) often find carework too strenuous; 22.7% of caregivers find that long-term care has a negative effect on friendships, and one in five (18.8%) has existential anxiety or fear of the future.

Caregiving relatives not only suffer from higher morbidity, they also suffer greater morbidity through their carework. At 48.7% in December 2017, the prevalence of mental illness among principal caregivers is very high. In a comparative population in terms of age structure and gender, only 42.5 % of non-caregivers is similarly diagnosed. Morbidity among principal carers has increased by 9.1 percent points over the last five years and only 5.7 percent points in the comparative group.

Future Scenarios for Principal Caregivers

Projections from the survey of BARMER insurees in 2018 suggest that in total at least 185,000 principal caregivers are on the verge of giving up long-term carework. In addition, over a million principal caregivers only want to continue providing long-term care as long as the situation prevailing at the time of the survey does not change. As, the care situation does tend to deteriorate over time, however, it cannot be assumed that this group of carers will continue to provide long-term care. All in all, then, the situation is quite alarming.

Principal caregivers would like less red tape when submitting applications, would like to be able to always contact the same expert on specific matters, would like to be better informed about long-term care insurance benefits and services and about where help can be sought. It is of prime importance to people in need of care to know where they can get help. Clearly, there is a need for the central actors in long-term care and in politics to redress the situation.

Download (in German):
BARMER Long-Term Care Report 2018
Statement by Professor Rothgang for the Press Conference 
Presentation by Professor Rothgang for the Press Conference


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Dr. rer. pol. Rolf Müller
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58554
E-Mail: rmint@uni-bremen.de

Cover Innovation Report 2018Cover Innovation Report 2018
More green traffic lights than in recent years.

The Innovation Report has been published annually since 2013 by Professor Gerd Glaeske und Professor Wolf-Dieter Ludwig with the support of the Techniker Krankenkasse (TK). This report combines healthcare provision research with the evaluation of new medicines that were first offered three years ago and that have undergone an early assessment by AMNOG criteria. In this respect, the innovation report offers a kind of "late assessment" of the drugs from the year 2015. The increasing marketing of orphan drugs can also be seen in this year's Innovation Report, as well as the trend towards accelerated market entry of pharmaceuticals.

The Innovation Report 2018 critically evaluates the new drugs launched in 2015 into the pharmaceutical market for German health insurance. Many patients with serious diseases that have been only symptomatically treatable live in the hope of being cured by newly developed medicines. These include, for example, drug therapies for Alzheimer’s dementia - which are dealt with in a separate chapter in this Report - but also new medicines for the treatment of malignant diseases. In particular, with regard to the former condition, information is regularly promulgated that raises hopes of a cure, but so far there has been no real therapeutic breakthrough with regard to finding a cure for Alzheimer’s dementia.

Altogether, 32 of the 37 pharmaceutical products introduced in 2015 are included in the Innovation Report 2018. In the report, there are 7 positive and 10 negative evaluations (indicated by a green or red traffic light respectively). Numbering nearly 50 % of the products, the largest proportion is registered as having at least partial additional benefits, which is indicated by a yellow traffic light.

Orphan drugs, used to treat rare diseases which afflict no more than 5 persons per 10,000 according to the EU definition, account for a third of the new drugs. In addition, there is a clear lack of new antibiotics or drugs available in the market for treating most “other neurological diseases” and mental disorders. 

Download Innovation Report 2018:
Long version (in German)
Short version (in German)

Download:
Statement for the press conference by Gerd Glaeske (in German)
Slides for the press conference by Gerd Glaeske (in German)


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Sigrid LupieriSigrid Lupieri
Lupieri is a PhD candidate at the University of Cambridge and will stay in Bremen for three months, collaborating with the SOCIUM and the CRC 1342 "Global Dynamics of Social Policy".

Thanks to the generous support of an Alexander von Humboldt Foundation grant, we are delighted to be hosting Sigrid Lupieri at the CRC and SOCIUM as a guest researcher for the period of 01 September to 30 November 2018. As a PhD candidate at the University of Cambridge, her research analyses the factors influencing the allocation of health care resources to older Syrian refugees in Jordan.

Ms. Lupieri's previous experience includes working at UNESCO and UNDP in New Delhi and New York, as well as several years as a journalist in Armenia, Georgia, Germany and the U.S. She holds master’s degrees in journalism (Northwestern University) and modern European history (University of Cambridge), and a BA in foreign languages and literatures from the University of Udine, Italy. During her stay at our center, Ms. Lupieri will be working in close collaboration with the A04 project "Global developments in health care systems and long-term care services".


Contact:
Dr. Lorraine Frisina Doetter
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58561
E-Mail: frisina@uni-bremen.de