Why should the German approach to health economic evaluation differ so markedly from approaches in other EU Member States?

The Efficiency Frontier is the method by which German policy makers establish the cost-effectiveness of new pharmaceutical technologies. In a new paper, Corinna Klingler, Sara Shah, Anthony Barron and John Wright argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Using information gathered in interviews with key stakeholders, the authors contend that the Efficiency Frontier method responds to an environment characterized by a need to deny, or to ignore, the need to ration healthcare, and a deep aversion to describing the benefits of health gains in monetary terms.