Preparing price negotiations with the GKV-SV

SKC’s top 5 essentials

Tue, 2023 / 01 / 10
After the resolution of the German Federal Joint Committee (G-BA) on the benefit assessment within the AMNOG process has been published, the pharmaceutical company usually receives an invitation to negotiate the reimbursement price with the German National Association of Statutory Health Insurance Funds (GKV-SV) within two working days.

The pharmaceutical company negotiates the new reimbursement price with the GKV-SV within six months after publication of the G-BA resolution. The first price negotiation usually takes place within the immediate four weeks after the resolution, which is why the preparation of the annexes and the development of the overall strategy should start directly after, or even before the publication of the resolution.

Negotiations with the GKV-SV are a particular challenge for many companies. With around 500 completed negotiations*, the GKV-SV has a great cumulative experience, which is comprised by few individuals. This gives it an unrivaled advantage over the experience of individual pharmaceutical companies. The concept for a successful negotiation therefore consists of the interplay of a well thought out negotiation strategy, the preparation of the annexes aligned with the strategy and, above all, a coordinated and well-prepared negotiation team. It is important that the overall strategy developed with the help of one's own strengths and weaknesses can be authentically represented by the negotiating team. Hence, it is helpful to anticipate the position of the GKV-SV, to prepare the possible counterarguments of this position and to define the respective roles of the members within the negotiation team.

At SKC, we have successfully supported many pharmaceutical companies and their individual products in more than 80 price negotiations and have seen the GKV-SV reacting to a wide variety of strategies. We use this experience and anticipated reactions of the GKV-SV to develop an optimal negotiation strategy together with our clients.

*SKC has established its own database – the Market Access Intelligence Database (MAIS) including all AMNOG procedures with the respective outcome of the benefit assessment and the results of the price negotiation.

SKC's Top 5 Essentials for preparing the price negotiations with the GKV-SV are:

  1. Build up a defined but flexible negotiation and pricing strategy, based on a deep understanding of price anchors, value creation mechanisms, and GKV-SV perspective. Be prepared for any potential scenario: arbitration board, legal chances, competitors entering the market, new clinical guidelines.
  2. Thoroughly analyze the G-BA resolution, the benefit assessment, especially the assessment of the added benefit, as the main price anchor, and the dossier for the price negotiations.
  3. Develop a thought through offer strategy based on robust rationales addressing the anticipated pain points of the GKV-SV. Use an easy-to-handle excel-based offer tool to be able to flexibly react to counteroffers.
  4. Prepare all the necessary documents (annexes, contract synopsis, company presentation) in detail and on time with keeping the overall strategy in mind.
  5. Train the price negotiation team in negotiation skills to be prepared for any situation.

About the author

Ihr Ansprechpartner  Tim Ebbecke, Ph.D.
Tim Ebbecke, Ph.D.
M.Sc. Biology
Fon: +49 511 64 68 14 – 0
Fax: +49 511 64 68 14 18

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