Coalition paper of the AG “Gesundheit und Pflege” (Health and Care Working Group)

Stronger limitation of drug costs by the health insurance funds

Fri, 2021 / 11 / 19
The six-page paper of the working group "Gesundheit und Pflege" defines the health policy plans and goals for the currently elaborated possible coalition of the SPD, Grüne and FDP in Germany. With regard to the AMNOG and drug costs, the parties aim, as expected, to make significant changes to reduce costs in the upcoming legislative period.

At SKC, we follow the developments for our clients and directly incorporate the relevant political decisions into our daily business. The coalition paper contains the following major changes:

  • Reduction of the free pricing period: negotiated rebated price starting from the 7th month (backdated) after market entry (formerly from the 13th month)
  • Increase of the formal manufacturer rebate §130a SGB V: Increase of the current manufacturer discount for patent-protected drugs to 16% (abolished in 2013) while maintaining the regulations on the price moratorium*
  • Reduction of VAT on pharmaceuticals: VAT reduction on pharmaceuticals to 7 % while maintaining the existing price moratorium*
  • Strengthening the importance of care and nursing: voice for the Deutscher Pflegerat (DPR, "German Nursing Council") in the Federal Joint Committee (G-BA)
  • Reform of the G-BA: acceleration of the decisions of the self-administration, strengthening of patient representation for care and nursing (see above), and other health care professions as soon as they are affected
  • Advance transfer to outpatient setting ("outpatientization"): Implement sectoral remuneration for appropriate services through so-called hybrid DRGs

The application of the red pen, in particular through a) the reduction of the free pricing period, i. e. the 50%-reduction of the currently one-year period of free pricing by the pharmaceutical entrepreneur (pU) after market access, as well as b) the increase of the manufacturer's rebate to 16%, had already been expected to some extent. Both have a decisive influence on the selected pricing strategy of the pU with regard to the significance of Germany as a central reference country and the most important European market. It remains to be seen how quickly the respective targets will be implemented.

SKC follows, analyzes and anticipates the political decisions and their respective implementations in detail and incorporates these directly into the consultations with clients.

*Both aspects were listed in the last version of the working paper, but cannot be found in the final published coalition paper.

Sources:

Koalitionsvertrag 2021-2025 - Mehr Fortschritt wagen
Der Spiegel - Koalitionsvertrag der Ampelparteien
SKC Interna

About the author

Ihr Ansprechpartner Dr. rer. nat. Ingo Hantke
Dr. rer. nat. Ingo Hantke
M. Sc. Life Science
Fon: +49 511 64 68 14 – 0
Fax: +49 511 64 68 14 18
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