First EFIC® Symposium Societal Impact of Pain - SIP

66
Norbert Klusen
Prof. Dr. Norbert Klusen
CEO of Techniker Krankenkasse, Germany
Pain and pain therapy is a topic of increasing
relevance in European societies and partly due
to increasing workload and stress. According
to findings the Techniker Krankenkasse (TK), a
large German insurance fund, one in ten sick
leave days of German employees are caused
by serious back pain, and two thirds of the German
population are reported to suffer at least
temporarily from headaches. The data show
that even a worrisome number of children is
affected: one in two pupils at primary school
suffer from tension headache or migraine.
Thus, a crucial element and indicator for the
quality of a patient-oriented health care system
is the provision of quick access to appropriate
and effective structures of pain therapy. For
optimal results in pain therapy broad access
to efficient medication has to be accompanied
by interdisciplinary and coordinated structures
of managed care. Successful managed care
models for pain therapy have to comprise
multimodal concepts of pain treatment, structures
encouraging active patient participation,
and coordinated treatment structures in an
interdisciplinary network.
Various managed care plans of TK combine
these requirements for interdisciplinary pain
treatment successfully. In different models of
integrated care TK provides co-ordinated
multimodal pain therapy for back pain and migraine
in regional networks. Treatment plans
are flanked by programs promoting active
patient participation, e.g. by stimulating virtual
dialogues in order to facilitate communication
between doctors and patients with low back
pain, or by giving patients the opportunity for a
second expert's opinion prior to spine operations.
The success of managed care concepts
in pain therapy relies heavily on well-functioning
cooperations between insurance companies
and involved health care professionals, i.e. doc-
tors of various qualifications and therapists.
After a first analysis of both medical treatment
situation and patients' wishes, treatment parameters
and coordinated paths have to be
developed together and put into practice according
to patients' needs. Experiences show
that coordinated models work best if they are
focused on limited geographic regions and allow
individualized pain treatment programs.
Even though there is no doubt about the need
of coordinated care concepts in pain therapy,
the concrete benefit and cost-effectiveness-relation
of managed care plans have to be evaluated
by supporting health care research. Future
progress in health care research by pain
cooperations will depend on the disposition of
the partners to bring together their varying
ideas on methodical issues like data design and
evaluation parameters.
Limited financial resources continue to be a
central challenge for health care supply in almost
every country. This has become an even
larger challenge in Germany since a central
health fund has been introduced which gives
insurance companies even less financial room
for making investments in innovative managed
care concepts and health care research. Future
concepts and research in pain therapy
will largely rely on the ability of the cooperating
partners to find ways of generating the necessary
resources.
Graduated in Business Management and PhD
in Economics; President and Chief Executive
Officer at the Techniker Krankenkasse (TK), a
leading German health insurance company;
Professor of International Health Care Policy
and Systems at Leibniz University Hanover,
Professor of Health Care Economics and
Health Care Policy at the University of Applied
Sciences of Western Saxony, Visiting professor
at the University of Michigan and First
Executive in residence of Griffith Leadership
Center for Health Management and Policy, Ann
Arbor, USA (2009)