ArticleThe International journal of health planning and management2026
The Efficiency of the German Healthcare System: Some Puzzling Findings.
Article in The International journal of health planning and management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article examines the cost-effectiveness of the German healthcare system from the perspective of statutory health insurance (SHI). Using data for 2011-2014-the most recent period for which consistent national inputs are available-we compare a marginal, system-wide cost-effectiveness ratio with the cost-effectiveness of newly approved cancer drugs. The analysis indicates that the German healthcare system incurred costs per life-year gained that were broadly comparable to the incremental cost-effectiveness ratios reported for many new cancer drugs. Sensitivity analyses varying the attribution of mortality reduction to healthcare do not materially alter this comparison. Although evidence of overuse and inefficiency in the German healthcare system is documented across multiple sectors, the available evidence does not clearly identify a single domain sufficiently large to explain the aggregate pattern. This raises the hypothesis that inefficiency may be diffuse, or that structural features common to high-income health systems-such as diminishing marginal returns to health spending-play an important role. While the empirical estimates rely on data from roughly a decade ago, subsequent trends in treatment costs and life expectancy provide little indication that the underlying tension has dissipated. The findings highlight the need for more systematic cost-effectiveness analysis across sectors, alongside rigorous evaluation of reforms and consideration of institutional and political constraints affecting implementation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.