gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Strategies for Maintenance of Hospital Reimbursement: Delivery and Documentation of Drugs Covered by an Additional Reimbursement Fee

Meeting Abstract

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  • corresponding author presenting/speaker Matthäus Krych - Medizinische Klinik und Poliklinik III – Großhadern, Klinikum der Universität München, Deutschland
  • M. Thalheimer - Abteilung Innere Medizin V, Medizinische Universitätsklinik Heidelberg
  • H. Ostermann - Medizinische Klinik und Poliklinik III – Großhadern, Klinikum der Universität München

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPE642

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Krych et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: In the year 2005 additional reimbursement fees (ZE) have been implemented for expensive pharmaceuticals like antifungal drugs, growth factors or monoclonal antibodies. ZEs have led to a much more accurate description of costly cases which now can be detached form those creating average costs only. Oncological departments can profit at the utmost of this improvement since by tradition this medical sector used expensive drugs extensively. However for each drug and patient an accurate electronic documentation of the extent and the manner is mandatory and overstrains routine hospital logistics.

Methods: Two different methods to assure a complete and correct documentation of delivered drugs covered by a ZE have been introduced at two large oncological departments in Heidelberg and Munich. The first established a system in which ZE – drugs only can be ordered for individual patients and developed a logistic system in which drugs packed in individualized colour coded cases follow patients when they change wards. Additional depots ensure the supply with ZE – drugs needed in emergency. The latter left the drug ordering system untouched but initiated an electronic documentation of the amounts used which then are assigned to individual patients. By using barcode scanners this work can be done by nurses easily.

Results: Both systems proofed to be efficient and allowed to allocate >95 % of ZE drugs delivered to oncological wards to individual patients. In the Heidelberg model the hospital pharmacy guarantees for the correct attribution of drugs to patients, whereas in the Munich model acquisition is managed by the nursing staff. Both models are time efficient, leave to clear responsibilities and spare highly trained physicians from documentary work.

Discussion: Hospital managements have to reflect how to ensure an accurate ZE documentation. Since ZEs represent a considerable portion in the remuneration for oncological patients, oncological departments should substantially contribute to the development of strategies for maintaining and improving departmental remuneration. Since further additional fees are reimbursed for new innovative drugs (NUB) these logistic systems seem even to gain more importance in the future.