Disposables for the ICU: who has a say in German hospitals.
A disposable for intensive care is not listed by the head of department alone. Nursing, infection control and purchasing share the decision — and the price has to fit within a DRG lump sum. These products have been our focus since 1999.
- Decision-makers
- Medical lead, ICU nursing, infection control and purchasing
- Reimbursement
- Usually part of the DRG lump sum, not reimbursed separately
- Lever
- Clinical test at a university hospital before roll-out
- References
- Zassi, NanoVibronix, Rüsch — ICU, urology, thoracic surgery
Why ICU disposables follow their own rules
A hospital buys a large capital device once, after long investment planning. A disposable for the ICU is used every day, applied by many hands and paid for out of running material costs. That leads to three particularities:
- More decision-makers. Nursing applies the product, infection control assesses the infection risk, purchasing compares prices within the framework agreement. The medical lead matters, but does not decide alone.
- Constant price comparison. Because the product sits within the DRG lump sum, it competes with the cheapest available alternative.
- High switching costs in daily routine. A new product means new handling, new training, new standards. A ward only switches when the benefit is tangible.
Who has a say in the hospital
| Function | What it looks at |
|---|---|
| Medical lead, intensive care | Clinical evidence, patient safety, outcome |
| ICU nursing and nursing management | Handling, time required, workload, training needs |
| Infection control | Infection prevention, consistency with KRINKO recommendations (Germany’s infection prevention commission) |
| Purchasing and materials management | Price, purchasing group framework agreements, supply reliability |
Many hospitals bring these perspectives together in a product or standardisation committee. A manufacturer who addresses only one of these groups is often held up by another. That is why our Board of Experts includes not only physicians but also nursing directors, hospital purchasing and medical engineering.
The price has to fit the lump sum
As a rule, disposables are not reimbursed separately. Certain high-cost products qualify for additional fees, and new methods can take the NUB route via the InEK institute. For most disposables, the arithmetic stays simple: the premium has to pay off within the lump sum.
The arguments for it rarely lie in the unit price, but in the process:
- Nursing time. Fewer changes, less cleaning effort, fewer steps per shift.
- Complications. Avoided infections, skin damage or follow-up procedures.
- Length of stay. Every day less in the ICU relieves the lump sum.
These arguments need data from a German hospital. Studies from your home market help, but they do not replace German experience.
The product trial decides
Before a disposable is listed, a ward usually tests it for a limited period. Whether the trial succeeds depends on preparation:
- The right hospital. A university hospital or tertiary care centre with case volumes in your indication and leadership open to new procedures.
- Train nursing first. If you do not win over the users, you lose the trial on the night shift.
- Involve infection control early. Questions on infection prevention will come anyway — better before the trial than after.
- Evaluation for purchasing. Results are prepared so that purchasing can champion them in the committee.
This is how we proceeded with Zassi’s bowel management system: first the clinical test at Göttingen University Hospital, then roll-out across university hospitals and tertiary care centres. By 2005, Germany was the strongest market in Europe.
Supply reliability is a sales argument
An ICU that runs out of material switches product. For disposables, warehousing and delivery are therefore part of sales. Our group company DSW Logistik stores products in Germany in line with GDP and delivers directly to hospitals. Your German company handles orders, invoices and complaints.
Proven in our mandates
Frequently asked questions
- Who decides on a new disposable in a German hospital?
- Rarely one person. Typically the medical lead of the ICU, nursing management, infection control staff and purchasing all have to agree. Many hospitals have a product or standardisation committee for this. If you only convince the head of department, you often fail at nursing or purchasing.
- Will our product be reimbursed separately?
- Usually not. Disposables are costs within the DRG lump sum. Certain expensive products qualify for additional fees (Zusatzentgelte), and new methods can follow the NUB route via the InEK institute. For most disposables, the premium has to be justified through process costs, nursing time or avoided complications.
- How does a product trial in the ICU work?
- Usually as a limited trial on one ward, with samples, user training and a documented evaluation. What matters is that nursing and infection control are involved from the start and that the results are prepared so purchasing can use them.
- Who handles warehousing and delivery?
- Our group company DSW Logistik stores products in line with GDP and delivers to hospitals. With disposables in regular use, reliable replenishment often counts as much as price.