gms | German Medical Science

11. Jahrestagung 2004 der GAA

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

30.09. bis 01.10.2004, Jena

GMG caused Changes in Therapeutic Selections within the Treatment of Onychomycosis

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker H. Ulbricht - Aventis Pharma Deutschland, Bad Soden
  • J. Knollmeyer - Aventis Pharma Deutschland, Bad Soden

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA) e.V.. 11. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Jena, 30.09.-01.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gaa20

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Veröffentlicht: 30. September 2004

© 2004 Ulbricht et al.
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Due to the commencement of the GMG ( Health Modernization Act) clear changes concerning the therapeutic attempts for the treatment of an onychomycosis can be notified.

More than 1600 dermatological products are expenditured from reimbursement by German's GKV.

This includes antimycotic nail lacquers that are used primarily for the treatment of onychomycosis.

Onychomycosis is regarded to be an infectious disease caused by pathopotential fungi, that is likely to evoke the complete loss of the protecting nail plate, or could infect the neighbouring nails and which could transfer to others.

Within diabetic or immunosuppressive patients onychomycosis can be considered as a pathfinder for erysipelas or other bacterial illnesses.

Aim of the Study

Due to the new legal regulations the question arises, whether there will be a change in the treatment of onychomycosis concerning therapeutic patterns, for topical treatment can no longer be refunded.

In order to find out we conducted a migration analysis using the former market leader Nagel Batrafen as a ledger.

Material and Methods

Based on the results of the Regional Pharmacy Market (RPM) the disposed preparations for onychomycosis treatment used in the 1st Quarter of 2003 were compared with those used in the 1st Quarter 2004.

Migration analysis was raised as well for the total market as for 28 defined sub-segments. The latter served to point out possible existing regional differences.


Nationwide it could be observed definitely that no longer reimbursed topic market leader Nagel Batrafen substantially debited at the expense of oral antifungals.

All known oral antimycotics assigned for the treatment of onychomycosis could obtain a more or less explicit growth rate concerning sales.

The proportional increases of sales varies from 4 % (Itraconazol; original and reimports) over 9.4% (Terbinafin and reimport) to 38,9% for Fluconazoles.

The overall trend found in the federal territory corresponds well to regional tendencies.

Further on about 45,000 patients were admitted less to an antifungal therapy in the comparison period of the previous year.


One of the main aims of Health Modernization Act was to save expenses by foreclosure of pharmacy requiring medicaments from GKV refunding.

If treatment of onychomycosis quotes an example we can point out clearly that the savings effect is not obtained.

Instead of the lower priced topic alternatives more expensive oral drugs are used.

Noticed partial therapeutic nihilism is still worse:

Necessary treatment is possibly withheld from patients, for former existing low priced alternatives are no longer reimbursable and the oral alternatives would blow up budgets respectively.