Germany’s Medical Service of the Statutory Health Insurance (MDS) is calling for increased transparency regarding the potential risks associated with individually paid health services (IGeL). The MDS issued a statement Tuesday asserting that many IGeL do not deliver on their promised benefits.
“Many self-pay services cause more harm than good” stated Stefan Gronemeyer, head of the MDS. A particular concern is the lack of comprehensive information provided to patients in medical practices about potential adverse effects. “Practices should be required to regularly offer independently created, scientifically-based evaluations and information”. The organization also suggested a cooling-off period, advocating that IGeL should not be administered on the same day they are offered.
Stefan Lange, Head of Evidence-Based Medicine at the MDS, highlighted the results of studies examining hyaluronic acid injections for hip and knee osteoarthritis. “The evaluation of these studies reveals that the harm outweighs the benefit” he said. “The risk of adverse events is significantly increased and the associated pain reduction is so minimal that it is clinically insignificant.
Hyaluronic acid injections are frequently offered as an IGeL in orthopedics for individuals with knee and hip osteoarthritis. The injections, administered directly into the affected joint, aim to alleviate the effects of cartilage degradation by supplementing synovial fluid with hyaluronic acid, intending to improve joint lubrication and reduce discomfort.
The expert organization also found the evidence base for extracorporeal shock wave therapy (ESWT) for conditions like calcium deposits in the shoulder (calcifying tendinitis) and tennis elbow to be inconclusive. The team at the IGeL-Monitor found limited robust studies evaluating the effectiveness of ESWT for these conditions, with some studies presenting conflicting results regarding benefits and risks. Overall, the assessment of both therapies was deemed “unclear”.
Statutory insured individuals in Germany spend at least 2.4 billion euros annually on IGeL, with orthopedic services accounting for approximately 400 million euros of that total.
