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However, hospital reimbursement data for ISA is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary objective of this study was to analyse the different perspectives of relevant stakeholders and the (dis)incentives for the administration of ISA in Germany. To that aim, the health economic effects of using ISA from a hospital management perspective were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>Based on principal\u2010agent theory (PAT), the perspectives of (a) the patient (principal) as well as (b) physicians, (c) pharmacists and iv. hospital managers (all agents) were analysed. For the evaluation of the cost\u2010containment and reimbursement strategies of ISA, the German diagnosis\u2010related group (G\u2010DRG) system was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hospitals individually negotiating additional payments for innovative treatment procedures (zusatzentgelte [ZE]) within the G\u2010DRG system is a key element of hospital management for the reduction of total healthcare expenditure. Our analysis demonstrated the beneficial role of ISA in healthcare resource utilisation, primarily due to a shortened overall length of hospital stay. Depending on underlying disease, coded G\u2010DRG and ISA formulation, large differences in total reimbursement and the amount of ZE was shown. The PAT demonstrated disincentives for hospital managers to use innovative drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the PAT, beneficial, detrimental and indifferent perspectives of different stakeholders regarding the usage of ISA were shown. A reduction of bureaucratic hurdles is needed in Germany for the extension of effective and innovative antifungal treatment strategies with ISA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13192","type":"journal-article","created":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T12:53:58Z","timestamp":1602248038000},"page":"86-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Principal\u2010agent theory\u2010based cost and reimbursement structures of isavuconazole treatment in German hospitals"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4907-7490","authenticated-orcid":false,"given":"Florian","family":"Kron","sequence":"first","affiliation":[{"name":"FOM University of Applied Sciences Cologne Germany"},{"name":"Department I of Internal Medicine University Hospital of Cologne Cologne Germany"},{"name":"VITIS Healthcare Group Cologne Germany"},{"name":"Center for Integrated Oncology K\u00f6ln Bonn CIO K\u00f6ln University Hospital of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian M.","family":"Wingen\u2010Heimann","sequence":"additional","affiliation":[{"name":"FOM University of Applied Sciences Cologne Germany"},{"name":"Department I of Internal Medicine University Hospital of Cologne Cologne Germany"},{"name":"VITIS Healthcare Group Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Jeck","sequence":"additional","affiliation":[{"name":"VITIS Healthcare Group Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Lazzaro","sequence":"additional","affiliation":[{"name":"Health Economics Research and Consulting Studio di Economia Sanitaria Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A.","family":"Cornely","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine University Hospital of Cologne Cologne Germany"},{"name":"Center for Integrated Oncology K\u00f6ln Bonn CIO K\u00f6ln University Hospital of Cologne Cologne Germany"},{"name":"Clinical Trials Centre Cologne (ZKS K\u00f6ln) University Hospital of Cologne Cologne Germany"},{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thielscher","sequence":"additional","affiliation":[{"name":"FOM University of Applied Sciences Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-017-0183-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx032"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767110-00004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw326"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.01.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01159-9"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13082"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13096"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-29"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2230-8"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2018.11.003"},{"key":"e_1_2_8_13_1","unstructured":"The Organisation for Economic Co\u2010operation and Development (OECD).Healthcare costs unsustainable in advanced economies without reform.2015.http:\/\/www.oecd.org\/health\/healthcarecostsunsustainableinadvancedeconomieswithoutreform.htm. 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