Excellent clinical studies as an answer to the dilemma faced by public health insurance companies in the reimbursement of DiGA

Excellent clinical studies as an answer to the dilemma of statutory health insurance companies — not only in the reimbursement of DiGA

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In its latest and third DiGA report, the National Association of Statutory Health Insurance Funds for the Supply of Digital Health Applications (DiGA) summarizes. The board member at the National Association of Statutory Health Insurance Funds, Stefanie Stoff-Ahnis, demands equal treatment with other benefits reimbursed by statutory health insurance funds. DiGA is only granted the “potential” of medical benefit if there are “low entry requirements for DiGA when proving its benefits” and insufficient “economic efficiency.”

These statements are an affront to companies, which are undergoing a very complex process seriously and with great effort for innovative therapies. Equally against those responsible at the Federal Office for Drugs and Medical Devices (BfArM), who interpret the legal framework in such a way that even the provisional inclusion of a DiGA in the so-called DIGA directory requires higher standards of study quality and scientific evidence than the medical devices currently reimbursed, e.g. in the list of aids of the National Association of Statutory Health Insurance Funds, or when known useless therapies have ever been the case.

This undifferentiated and ill-considered presentation picked up by the press not only harms manufacturers but also all patients by preventing real innovation. Instead, the same scientific evidence requirements apply to all treatment options and fair payments for all services and to all care providers in this country should be considered and implemented based on facts.