Medikamentöse Therapie der renalen Osteopathie unter Berücksichtigung sozialmedizinischer Aspekte

Zusammenfassung

Zur Therapie des sekundären Hyperparathyreoidismus infolge einer Niereninsuffizienz und der damit verbundenen renalen Osteopathie stehen neben den Phosphatbindern Vitamin D und Vitamin D(-Metaboliten) sowie Kalzium-Rezeptor-“Sensitizer” (Cinacalcet) als Arzneimittel zur Verfügung. Abhängig davon, ob diese als apothekenpflichtige oder als verschreibungspflichtige Arzneimittel deklariert sind, müssen bei der Verordnung dieser Medikamente im Rahmen der vertragsärztlichen Versorgung der Patienten unterschiedliche Vorschriften beachtet werden. Zusätzlich muss beachtet werden, dass auch wirkstoffgleiche Arzneimittel in unterschiedlichen Indikationen zugelassen sind, was deren Verordnungsfähigkeit im Rahmen der vertragsärztlichen Versorgung je nach der jeweils zugelassenen Indikation einschränkt.

Summary

There are phosphate binders, vitamin D (metabolites), and a calcium receptor sensitizer for the drug therapy of secondary hyperparathyroidism due to renal insufficiency and therefore renal osteopathy. Depending on their legal status, i. e. distribution only by pharmacy or additional requirement of physician’s prescription, several different regulations have to be regarded before these drugs can be prescribed on account of the German social health insurance. Additionally it has to be taken into account that different drugs containing the same active substance have different legal indications of usage causing a restriction in prescribing these drugs on account of the German social health insurance depending on their labelled indication.

Schlüsselwörter

Phosphatbinder - Vitamin D(-Derivate) - Kalzimimetikum - Off-Label-Use - Sozialmedizin

Keywords

Phosphate binders - vitamin D(-derivatives) - calcimimetic - off label use - social medicine

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