Accounting for tastes: a German perspective on the inclusion of patient preferences in healthcare.

Internationally, there has been a movement in medicine to better involve patients in decision making, whether it be at the individual or aggregate level. However, the German health sector has been slow to understand and accommodate the preferences of patients. This paper discusses the reasons why and attempts to highlight some of the consequences of not involving patients in healthcare decision making within the German context. We argue that a fundamental paradigm shift at all levels of the German health system, including better doctor/patient communication, is necessary for more choices to be available to patients and to better reflect patient preferences in centralised healthcare decision making. The newly created German health technology assessment agency (IQWiG; Institute for Quality and Economic Efficiency in the Health Care Sector) has indicated that they are interested in focusing on patient preferences, but there is a need for them to clarify what methods they deem suitable for doing so.