New Government in Germany

The coalition agreement reaffirms its commitment to Germany’s industrial healthcare sector, including the pharmaceutical industry. The pharma dialogue is to be continued, and the AMNOG process is to be further developed with a focus on “guardrails” and personalized medicine. Furthermore, supply security is to be strengthened by reshoring production of critical drugs and medical products back to Germany and Europe – a classic industrial policy approach.

However, these ambitions are clearly constrained by a fiscal reality: solid financing. Germany’s statutory health insurance (SHI) system is under significant financial strain. Contribution rates are rising, and the structural gap between revenues and expenditures is widening – and the government has committed itself to closing this gap. The implication: reimbursement conditions for pharmaceuticals are unlikely to improve.

For pharma and biotech companies, the outlook remains challenging. While there is political will to modernize the AMNOG process, limited fiscal room suggests increased pricing pressure, shorter free-pricing periods, and a generally more restrictive reimbursement climate.

Beyond medicines and reimbursement, the coalition outlines broader structural changes in the healthcare system. Key priorities include:

• Strengthening local community pharmacies, especially in rural areas, with increased remuneration and reduced bureaucracy.
• Restructuring the hospital landscape through the implementation of performance-based service groups and a focus on needs-based regional care.
• Accelerating telemedicine and digital triage, including hybrid-DRGs and a stronger role for digital platforms in early assessment and access coordination.

These structural changes reflect a healthcare system in transition – and pharma must understand how its role fits into this broader shift.

Nina Warken assumes leadership of the Ministry of Health with little prior experience in health policy. Her appointment follows the “Gröhe principle”: focus on administrative management rather than policy expertise. She will be supported by two seasoned health policy professionals – Tino Sorge and Georg Kippels – as parliamentary state secretaries.

It’s an intriguing setup: Warken is regarded as organized and communicative, while Kippels and Sorge are deeply embedded in the health policy landscape. In a field like pharmaceutical regulation, where expertise is essential, this trio could work well – provided that roles remain clearly defined and Warken can assert her coordination function effectively.

The key question is whether Warken can deliver the structural reforms urgently needed to balance innovation, access, and affordability – or whether the ministry will default to cautious management and crisis containment.

Despite some clear ambitions, many aspects of the coalition agreement remain vague. The planned expert commission for SHI financing, for instance, is not expected to deliver proposals until spring 2027. For pharma and biotech companies, this means continued uncertainty. Yet the pressure to act is enormous – both on the payer side and within the industry.

This is where sound local expertise becomes essential. We have been supporting pharmaceutical and biotech clients for more than 20 years with successful market access strategies in Germany – including AMNOG processes, reimbursement pathways, and strategic positioning. Our in-depth knowledge of the German system helps clients assess risks, identify opportunities, and navigate even volatile times with confidence.

The new coalition agreement sets the stage for a legislative period full of complex challenges: ensuring care provision, stabilizing health insurance finances, and strengthening Germany’s role as an innovation hub. However, the gap between political ambition and financial feasibility remains wide – with implications for the reality of drug reimbursement.

Nina Warken now faces the task of proving herself in a highly technical policy environment. The new government is in office, and a new chapter in German health policy begins. For the pharmaceutical industry, it’s time to stay alert, act flexibly – and choose the right partners with deep local expertise.