IQWiG continues its consolidation process

After a turbulent turn of the year, the German Institute for Quality and Efficiency in Health Care (IQWiG) further continued its consolidation process in 2008. The Institute has demonstrated its productivity with 11 final reports, 20 preliminary reports, 14 report plans, a revised version of its general methods, and a newly developed concept for the assessment of the cost-benefit relations of drugs.

In addition, IQWiG recruited more administrative staff, improved administrative procedures, and expanded its communication with stakeholders in the health care system. The Institute submitted a summary of its work at a press conference in Berlin on 10 December 2008.

Institute Director is content with the work of IQWiG

Professor Peter Sawicki, who has been the Institute's Director since its establishment in 2004, is content with the work of IQWiG, "We have again worked on several commissions and met the challenges imposed by the most recent Health Care Reform. With the Efficiency Frontier Analysis we have also presented a proposal for cost-benefit assessments.”

The Institute is currently incorporating comments on its cost-benefit assessment methods. In this context it is being advised by a working group of its Scientific Advisory Board. In parallel, the practicability of the methods is being tested in dry runs. Peter Sawicki notes, "I am optimistic that we will have a final version in the summer of 2009.”

The optimization of administrative procedures was an important issue in 2008

In the first years after its establishment, the Institute initially focussed on its scientific tasks and on ensuring the outcome quality of the reports. In 2008 there was increased concentration on the quality of the administrative process. More staff were recruited in the Department of Administration and in particular the expertise in legal affairs and project controlling was expanded.

A new award regulation as well as a behaviour codex were developed in cooperation with the Board of Directors of the IQWiG Foundation. An expert on the award of commissions now regularly monitors the call for tenders and the award of commissions to external experts and other service providers. Moreover, through a change in the Charter of the Foundation, the Chief Operating Officer (who is also Head of Administration) and the Legal Advisor were given the right to report directly to the Board of Directors and also to propose motions to this body.

These measures also serve to protect the Institute from critical attacks and defamation, as occurred most recently at the end of 2007. Claims made via the media that IQWiG had awarded commissions contrary to the rules were refuted by a detailed audit.

IQWiG maintains a dialogue with stakeholders and interest groups

With the increased stabilization, the Institute now has greater opportunity to intensify its communication with stakeholders in the health care system. In addition to the annual Autumn Symposium in Cologne, which took place at the end of November 2008 for the fourth time, and the second joint workshop with the German Health Research Council in October 2008 in Berlin, the Institute launched a new series of events in the early summer of this year: "IQWiG in dialogue”.

With about 350 participants, the IQWiG Symposium on Cost-Benefit Assessments was also well attended in February in Berlin. All events aim to offer interested scientific parties an insight into the Institute's work. This opportunity was also provided in a total of 18 oral debates held at IQWiG in 2008.

Transparency pays off

This kind of dialogue with various stakeholders and interest groups evidently pays off. Peter Sawicki states, "Criticism of the Institute has become more objective and more constructive.” Fierce attacks and controversies, also transmitted via the media, were no longer evident in 2008. "In the beginning we were merely a 'nuisance factor' for many, and they did not know what to make of us. As we consistently perform our work in a transparent manner, we are now well-known and have become an established and predictable constant within the German health care system.”

Court certifies that IQWiG works correctly

IQWiG was established in order to answer inherently controversial questions; protests were expected as a matter of course. "It is therefore very important that results are reliable, both from a scientific and procedural point of view,” says Peter Sawicki, "and this reliability is something that we have proven.” To date, IQWiG has not had to reverse a single one of its results.

For the first time, the judiciary has also certified that the Institute works correctly. With regard to the IQWiG report on rapid-acting insulin analogues in diabetes type 2, in a verdict of first instance, the Social Court in Berlin confirmed that all requirements of scientific accuracy and formal correctness had been fulfilled. Peter Sawicki hopes that this verdict has a "signal effect” and that the good reputation that IQWiG already has abroad will be confirmed and consolidated in Germany.

Agenda 2009: Intensive work on the reports, with accompanying evaluation

In 2008 IQWiG presented the preliminary results of 20 reports, i.e., the completion of the reports is expected in the course of the next year. For example, IQWiG will present the whole commission package on therapy options in Alzheimer's disease, as well as the benefit assessment on insulin analogues. The reports on asthma diagnosis in young children and screening for speech disorders will also be finalized.

An expertise on the organization processes in the Institute, which is planned for mid-2009, is designed to provide stimuli for the further development of IQWiG. This expertise will be prepared not only for IQWiG, but also for all other organizations funded by statutory health insurance (SHI). "This expertise is being performed at exactly the right time. On this basis, we will be better able to decide in which areas we can meaningfully further expand in the future and where not.” In 2009, some 15 million euros and 88.33 positions will be available to the Institute, which roughly corresponds to the budget of 2008.

Contact: Tel. ++49(0)221-35685-0, info@iqwig.de