/image alliance, Bernd von Jutrczenka
Berlin Last week, the Healthy Heart Act was removed from the agenda due to the lack of agreement on traffic lights. Tomorrow it will be decided in the federal cabinet. Apparently there were last-minute changes to the bill.
The project has so far received strong criticism from the professional public, especially with regard to the planned screening for familial hypercholesterolemia (FH) and the prescription of statins to children. The Federal Ministry of Health (BMG) had already wanted to issue a legal regulation for this purpose. Now the Federal Joint Committee (G-BA) regular.
In the cabinet draft, scientific findings and medical guidelines could be given greater importance than before when it comes to preventing serious cardiovascular events such as heart attacks or strokes and prescribing statins.
Federal Health Minister Karl Lauterbach (SPD) would thus agree with the recommendations presented yesterday by the Institute for Quality and Efficiency in Health Care (IQWiG) address cascade-based triage.
Until now, children and adolescents had a legal right to an early detection test for lipid metabolic diseases with a focus on familial hypercholesterolemia. To this end, health insurance companies must invite all children to the J1 test. This could now be regulated differently in the cabinet draft.
The changes should in any case please the parliamentary groups in the Bundestag. They had viewed parts of Lauterbach’s previous plans very critically or at least announced that the draft law would be examined closely, such as a consultation of the German medical journal showed among the parliamentary groups in the Bundestag.
Once the Healthy Heart Act has been approved by the cabinet, we will examine the bill carefully in the parliamentary process and will also discuss the issue of child and youth screenings again, said Bundestag member Johannes Wagner (Greens) when asked.
The current state of scientific research should be the basis for our political decisions, the doctor said. Even more than with adults, the benefits and risks of FH screening should be weighed up in children and adolescents, says Wagner. The possible psychological effects of the test as well as a possible false positive result should also be taken into account.
The publication of the IQWiG is undoubtedly interesting and should be part of the considerations for the Healthy Heart Act, emphasized Nezahat Baradari (SPD), member of the Bundestag. In times of increasing contributions, we are of course obliged to take a closer look at the benefits of new services.
However, the basic idea of the Healthy Heart Act is correct, as prevention in the German health system is demonstrably average, said Baradari. New methods, such as lipid screening for the early detection of familial hypercholesterolemia, are urgently needed to avoid increasing follow-up costs for the health system, said the specialist in pediatric and adolescent medicine.
The FDP considers the intention of the Healthy Heart Act to be good and correct. In the coalition agreement, it was agreed to move forward with prevention. But we must also set clear limits to the competence of the legislature, said Bundestag member Andrew Ullmann (FDP). German medical journal.
According to Ullmann, the legal framework should not determine medical measures in detail. We will leave it to the professional and practical level and the autonomous profession of doctors to decide based on evidence whenever possible, he said.
The opposition clearly supports the IQWiG proposal to only examine children and young people whose relatives have already developed FH. Dietrich Monstadt (CDU/CSU), a member of the Bundestag, criticises the large-scale prevention measures planned in the bill, which is to be enacted as part of the Healthy Heart Act.
Prevention must be scientifically based and should not be replaced by the widespread and thoughtless distribution of medicines, he said. Instead of promoting personal responsibility and health literacy, Lauterbach relies on state-imposed preventive measures, which in their current form are scientifically questionable and costly.
If there is a family history, doctors usually order cascade testing, as recommended by the IQWiG, said Monstadt (CDU/CSU). German medical journal with. Without family disposition or other reasons, this exam is expensive and unnecessary.
According to Die Linke, the IQWiG recommendation should be seen as a basis for political action. “We will look into this issue as part of the parliamentary consultation and press for improvements,” said Kathrin Vogler (Left Party). German medical journal.
Studies have shown questionable benefits of screening, especially in preventive medicine, Vogler says. Lauterbach’s waste of money is irresponsible in a time of fierce budget battles and continued premium increases for policyholders, she emphasized.
The AfD believes that the goal of reducing the number of cardiovascular diseases and associated deaths and increasing life expectancy is worth supporting. Even when it comes to preventive measures, evidence, effectiveness and cost-effectiveness should not be replaced by government regulations, said Bundestag member Martin Sichert (AfD). In this respect, the IQWiG proposal is fundamentally worth supporting.
The Healthy Heart Act aims to strengthen the prevention of cardiovascular diseases in the population and reduce the number of cardiovascular diseases. The plans include invitations for check-ups for adults aged 25, 35 and 50, as well as preventive exams for children and young people.
The law also includes an expansion of drug therapy for smoking cessation: in future, the insured’s claim will no longer be financed only in the event of severe tobacco addiction, but also more frequently than every three years.
Invitations for check-ups should be accompanied by vouchers that can be used to obtain advice and blood pressure measurement, as well as measurement of diabetes risk factors in pharmacies. © nfs/may/aerzteblatt.de