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Michael Schlander

Michael Schlander
Institute for Innovation & Valuation in Health Care (InnoVal-HC)

Professor

About

75
Publications
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392
Citations

Publications

Publications (75)
Preprint
Background Health state utility values (HSUVs) are essential input parameters to cost-utility analysis (CUA). Quality appraisal (QA) of systematic literature reviews (SLRs) of HSUVs is an important process towards the credibility of HSUVs estimates; yet, authors often overlook this crucial process. A scientifically developed and widely accepted QA...
Article
Introduction: Drug reimbursement decisions that spark public controversy are potential signals that processes used to reach such decisions do not adequately reflect society's goals. Such controversial decisions appear to be a characteristic of Quality Adjusted Life Year (QALY) based Incremental Cost Effectiveness Ratio (ICER) dominated decision-ma...
Article
Purpose: Pancreatic cancer is characterized by its high mortality, usually attributed to its diagnosis in already advanced stages. This article aims at presenting an overview of the economic burden of pancreatic cancer in Europe. Methods: A systematic literature review was conducted. It made use of the search engines EconLit, Google Scholar, Pub...
Article
The issue of COVID-19 vaccine allocation is still highly controversial on the international as well as on the national level (particularly in many low- and middle-income countries), and policy-makers worldwide struggle in striking a fair balance between different ethical principles of vaccine allocation, in particular maximum benefit, reciprocity,...
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In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, governments imposed various measures to decrease the rate of disease spread, and health care policy makers prioritized resource allocation to accommodate COVID-19 patients. We conducted a cross-sectional online survey in Germany (July 2020-June 2021) to assess the frequency of...
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Purpose Limited research suggests that cancer survivors have problems with insurance. Our study aimed to gain insight into the proportion of very long-term (14–24 years post-diagnosis) survivors of breast, colorectal, and prostate cancers who had problems with health (HI) and life (LI) insurance. Methods We used data from CAESAR (CAncEr Survivorsh...
Article
Background : Conventional cost-effectiveness analysis [CEA] using cost per QALY thresholds may counteract other incentives introduced to foster development of treatments for rare and ultra-rare diseases. Therefore, alternative economic evaluation methods were explored, namely Discrete Choice Experiment Willingness to Pay (DCE-WTP) and Relative Soci...
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The Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment (e.g., N9...
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Aims: To explore health technology assessment (HTA) outcomes of matched drug pairs by national agencies in Germany (Gemeinsamer Bundesausschuss, GBA), France (Haute Autorité de Santé, HAS) and England and Wales (NICE). Methods: We considered published GBA decisions, HAS reports and NICE guidance from January 2011 to June 2018. HTAs of matched pairs...
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Background Debate over the viability of the current commercial research and development (R&D) model is ongoing. A controversial theme is the cost of bringing a new molecular entity (NME) to market.Objective Our aim was to evaluate the range and suitability of published R&D cost estimates as to the degree to which they represent the actual costs of...
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Hospital certification has become an important measure to improve cancer care quality, with the potential effect of prolonging patient survival and reducing medical spending. However, yet to be explored is the cost-effectiveness of cancer care provided in certified hospitals, considering significant additional costs incurred from certification requ...
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Background and Aims Cancer treatments often require intensive use of healthcare services and limit patients’ ability to work, potentially causing them to become financially vulnerable. The present study is the first attempt to measure, on the German national level, the magnitude of absolute income loss after a cancer diagnosis. Methods This study...
Article
To analyse published evidence on the economic evaluation of risk‐based screening (RBS), a full systematic literature review was conducted. After a quality appraisal, we compared the cost‐effectiveness of risk‐based strategies (low‐risk, medium‐risk, and high‐risk) with no screening and age‐based screening. Studies were also analysed for modelling,...
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Background and aims Screening for colorectal cancer (CRC) can effectively reduce CRC incidence and mortality. Besides colonoscopy, detection of biomarkers in stool, blood or serum, including fecal immunochemical test (FIT), ColoGuard, pro Epicolon and PolypDx have recently been advanced. We aimed to identify characteristics of theoretical, highly e...
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Background: The European Medicine Agency granted marketing approval to 164 orphan medicinal products for rare diseases, among which 28 products intended for the treatment of hereditary metabolic diseases. Taking advantage of its privileged connection with 69 healthcare centres of excellence in this field, MetabERN, the European Reference Network f...
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It is widely accepted that with patient-centered care, attempting to meet the patient’s individual health needs and desired outcomes should be a primary objective of healthcare provision. In order to treat patients not only from a biological and clinical perspective but to also take into account the mental, psychosocial and financial dimensions of...
Article
Chimeric Antigen Receptor (CAR) T cell therapy is a promising immunotherapy with high acquisition costs, and it has raised concerns about affordability and sustainability in many countries. Furthermore, the current centralized production paradigm for the T cells is less than satisfactory. Therefore, several countries are exploring alternative T cel...
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There are at least two reasons why health technology assessment (HTA) agencies need to seek process-based solutions to support the legitimacy of healthcare resource allocation, ie, (i) in pluralistic societies, the existence of often conflicting and incommensurable claims (ie, the "fragmentation of value") and the lack of a broadly accepted, ethica...
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Introduction: Since P. Foot studied the trolley problem in 1967, it has been extensively discussed in ethics, decision theory, medicine, and other disciplines. With the invention of autonomous vehicles, it has become an important and urgent practical question. Methods: Three well-known, one new and one slightly changed versions of the trolley probl...
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Background & aims: Widespread screening for colorectal cancer (CRC) has reduced its incidence and mortality. Previous studies investigated the economic effects of CRC screening. We performed a systematic review to provide up-to-date evidence of the cost effectiveness of CRC screening strategies by answering 3 research questions. Methods: We sear...
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Background: The accountability for reasonableness (A4R) framework defines 4 conditions for legitimate healthcare coverage decision processes: Relevance, Publicity, Appeals, and Enforcement. The aim of this study was to reflect on how the diverse features of decision-making processes can be aligned with A4R conditions to guide decision-making towar...
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Being a victim of bullying is linked to various social, emotional and behavioral problems potentially leading to a reduced quality of life. Furthermore, victims of bullying may cause extensive costs for society, for example by an above-average need for healthcare services. The present study was designed to quantify the costs and the loss of quality...
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The economic evaluation which supports Health Technology Assessment (HTA) should inform policy makers of the value to society conferred by a given allocation of resources. However, neither the theory nor practise of economic evaluation satisfactorily reflect social values. Both are primarily concerned with efficiency, commonly conceptualised as the...
Article
Objectives: Our study explores whether, and how, different methodological choices are associated with different health technology assessment (HTA) outcomes. We focus on the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) in Germany and the National Institute for Health and Care Excellence (NICE) in England. Both agencies may be consider...
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As the cross-cultural use of outcome measures grows, it is important to determine whether these instruments are: appropriate for use in other settings, translated accurately, and perform in a similar manner to their original tools. This research aimed to compare the validity of the German translation of the ICECAP-A to the original English version...
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The economic evaluation of new health technologies to assess whether the value of the expected health benefits warrants the proposed additional costs has become an essential step in making novel interventions available to patients. This assessment of value is problematic because there exists no natural means to measure it. One approach is to assume...
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Nur ein geringer Teil der Gesundheitsausgaben in Deutschland wird für Prävention und Früherkennung aufgewendet. Das Rationale von Früherkennungsmaßnahmen ist es, (noch) symptomlose Personen mit dem Vor- oder Frühstadium einer Erkrankung zu identifizieren, um die krankheitsspezifische Morbidität und Mortalität zu reduzieren. Zu den anerkannten Evalu...
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Krebserkrankungen sind die zweithäufigste Todesursache in Deutschland und stehen im Ruf, hohe Kosten zu verursachen. Die gesundheitsökonomische Analyse der Krankheitskosten zeigt, dass die von bösartigen Erkrankungen verursachte Krankheitslast in der Tat für nahezu ein Fünftel der gesamten Krankheitslast, also der krankheitsbedingt verlorenen Leben...
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Background: Within (European) healthcare systems, the predominant goal for pharmaceutical expenditure is cost containment. This is due to a general belief among healthcare policy makers that pharmaceutical expenditure-driven by high prices-will be unsustainable unless further reforms are enacted. Objective: The aim of this paper is to provide mo...
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Introduction The Accountability for Reasonableness (A4R) framework addresses the legitimacy of coverage decision processes by defining four conditions for accountable and reasonable processes: Relevance, Publicity, Appeals, Implementation. Cost-per-quality-adjusted life year (QALY) and multicriteria-centered processes may have distinct implications...
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Introduction It is established that the current cost effectiveness health technology assessment (HTA) paradigm does not appropriately value rare disease technologies. Social willingness-to-pay (SWTP) has been suggested to be higher for rare disease technologies, it's inclusion into existing HTA framework could better reflect social preferences (SP)...
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Introduction Health state utilities measured by the generic multi-attribute utility instruments (MAUIs) differ. Empirical evidence suggests that some MAUIs are more sensitive than others in reflecting the quality of life (QoL) of patients in particular disease areas. Additionally, in order to estimate utilities based on cancer-specific health-relat...
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Rare diseases are an important public health issue with high unmet need. The introduction of the EU Regulation on orphan medicinal products (OMP) has been successful in stimulating investment in the research and development of OMPs. Despite this advancement, patients do not have universal access to these new medicines. There are many factors that a...
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Objectives To review recent studies reporting health care expenditures (budgetary impact) for orphan medicinal products (OMPs) in Europe and to contribute to our understanding of the cost drivers of nononcological OMPs by means of an empirical analysis in Germany. Methods A systematic search for relevant studies on rare diseases was conducted in P...
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INTRODUCTION Among economists, there is widespread agreement that the monetary valuation of health gains should reflect the preferences of those who will be affected by resource allocation decisions. In the context of Health Technology Assessments (HTAs), this view implies a need for reliable empirical estimates of the value of statistical life yea...
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INTRODUCTION Whereas Health Technology Assessments (HTAs) by the National Institute for Health and Care Excellence (NICE) rely heavily on cost utility analysis, HTAs by the German Institute for Quality and Efficiency in Health Care (IQWiG) and the Federal Joint Committee (GBA) focus on an assessment of comparative effectiveness, rejecting a cost pe...
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INTRODUCTION Evaluation of “value for money” is an important component of Health Technology Assessments (HTAs). It is often conceptualized as “cost effectiveness” or cost per (quality-adjusted) life year gained. Whether used in isolation or alongside further drivers of social value (such as priority for younger or more severely impaired patient gro...
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Over the last decade, the number of health economic evaluations has increased substantially in the field of child psychiatry. The objective of the present paper is to offer an overview of economic evaluations of child psychiatric drug treatment. Major electronic databases, as well as abstract booklets from international clinical and health economic...
Book
First in a new series on economic issues in the context of health care policy, Health Technology Assessments by the National Institute for Health and Clinical Excellence examines Britain’s highly acclaimed approach to cost-effectiveness analysis (CEA), and its international potential. The National Institute for Health and Clinical Excellence (NICE...
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Goal: The goal of this symposium is to identify ‘state-of-the-art’ strategies for the use of antipsychotic medications in the management of children and adolescents with major psychiatric disorders. Learning objectives: 1. Define pediatric populations for whom second-generation antipsychotics are indicated 2. Identify the role of second-generation...