Cost of photodynamic therapy

introduction

The cost of photodynamic therapy depends on the extent of the treatment and the effort. A treatment in dermatology is charged at around EUR 350 per session. In ophthalmology, these prices can be even higher.
In most cases, the health insurance does not cover these costs and they have to be borne by the patient himself.

Many resident dermatologists and dermatological clinics have been practicing photodynamic therapy since 2003. With the further development of photosensitizing substances, skin creams could be developed in dermatology and approved as drugs that were particularly effective. Even small doses are enough to create the appropriate effects.
With photodynamic therapy, in addition to a new treatment method, a large economic market has been opened up, which brings in millions of euros for clinics and resident doctors. The reason for this is the sometimes very high effectiveness (Cure rate).

In these cases the costs can be covered by the health insurance

Photodynamic therapy is a relatively new therapeutic branch, so the assumption of costs by the health insurance company has not yet been fully legally clarified.
In principle, the GBA (joint federal committee) defines the framework conditions for the catalog of services of the statutory health insurance companies.
The GOÄ (Schedule of Fees for Doctors) is used to actually calculate the costs.

Whether the costs are covered by the health insurance depends primarily on the illness.
However, it also plays a role with which health insurance company you are insured, as some insurance companies offer photodynamic therapy as an additional service.

There is an almost safe assumption of the costs only with private health insurances, however, as a privately insured person you should submit a cost assumption application to the insurance company beforehand.
The assumption of the costs is already best regulated for eye diseases, so with a few exceptions all costs are covered by the health insurance, regardless of whether you are privately or legally insured.

In the case of skin diseases, on the other hand, the danger of the disease plays a role in the assumption of costs.
Dental treatments, on the other hand, are usually not covered.

Other topics deal with costs: Private health insurance

You have to do that so that the costs are covered

In principle, in order to cover the costs for photodynamic therapy, an application must first be submitted to the respective health insurance company to cover the treatment costs.
This application should be made well before the start of the planned treatment, as it usually takes some time before such an application is approved.
Often the first application is rejected by the health insurance company.
However, if there is an important medical reason for the photodynamic therapy, the attending physician can draw up a letter of objection.
Often, however, there is a rejection.
In this case, photodynamic therapy must be applied for as an individual health service (IGEL).

Costs at the dermatologist

At the dermatologist, photodynamic therapy is mainly used to treat actinic keratosis.
This is a preliminary stage to skin cancer that responds particularly well to therapy.
In dermatology, too, therapy does not yet have a fixed position in the fee catalog, which is why it is often difficult to assume the costs.

However, depending on the size of the skin areas to be treated, costs of around 350 euros per session can be expected.
However, the costs can vary depending on the effort.
In addition, the number of sessions required for treatment varies greatly from person to person.

Dentist costs

At the dentist, photodynamic therapy is used to destroy bacterial pathogens that cause gingivitis.
The calculation of the cost of the therapy depends on the number of teeth affected and the severity of the disease.
The costs are based primarily on the time required for photodynamic therapy.

The calculation is then based on the private fee schedule for doctors.
Since the various variables are very different from one individual to another, it is not possible to specify the costs precisely.
The calculation is made in each individual case.
Since the costs are also based on the frequency of the therapy sessions, you have to reckon with costs between a few hundred to several thousand euros. Except in very special cases, the costs are not covered by the health insurance.

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Costs at the ophthalmologist

Photodynamic therapy is used by ophthalmologists to irradiate new blood vessels on the retina.
As a rule, the full costs for this are covered by the health insurance companies.
There are exceptions for a few special diseases in which photodynamic therapy is expected to provide no or only minimal improvement in vision.
In some special cases of age-related wet macular degeneration and visual acuity below 0.1, the costs are often no longer covered.

Historical basics

The basics and the therapeutic approach of photodynamic therapy have existed for a long time.
The first experiments with light-sensitizing substances and light irradiation were carried out as early as 1900.
A pharmacologist from Munich began to describe successful treatment with light at this early stage.
It took almost 90 years before photodynamic therapy was used correctly.

In 1990, photodynamic therapy was first used in dermatology as a test.
Here, however, no approved drug that is supposed to sensitize the skin was applied to the skin, but rather a chemical incorporated into the cream. It took another 15 years until photodynamic therapy was further developed, until it could be firmly integrated into the therapy principles of dermatology.