In the past year, drug spending in Germany for health insurance funds rose to a record high. As a reason for the increase, experts call expensive drugs for diseases such as hepatitis C or cancer.
Drug expenditure rises to record high
While doctors in Germany are prescribing more and more medicines, it has recently been reported that significantly fewer pills are prescribed in some cities than in others. Nationwide, the drug spending of health insurance have increased dramatically in recent years. As the Techniker Krankenkasse( TK) reports, they were in 2014 at a record high of 33 billion euros and in 2015 rose again by about five percent to about 35 billion euros. Accordingly, cost drivers are in particular expensive innovative medicines for hepatitis C and combination therapies for cancer.
Physicians in the dilemma
According to the TK-announcement, physicians, pharmaceutical companies, patients and health insurances have been demanding for a long time that the AMNOG and thus the results of the early benefit assessment must arrive at the doctor's office,"At present, some patients are not receiving new therapies fast enough, others are receiving expensive drugs that have no added benefit," said Tim Steimle, head of the TK department of pharmaceuticals, at the Pharma 2016 in Frankfurt."We therefore hope that the decisions of the Federal Joint Committee will be more closely involved in the prescription decision." Taking into account the results of the early benefit assessment in the medical guidelines would not only support physicians in the choice of therapy, but also the influence of the pharmaceutical industry on health careCounteract guidelines."The doctor is currently in conflict. He should take the guidelines into account, but they often give a different recommendation than the early benefit assessment, "says Steimle.
Health Insurance Benefits Industry
If the pharmaceutical company can not demonstrate any added benefit to older comparator therapies for a new drug as part of the early benefit assessment, it should not be priced higher. According to TK, this regulation should under no circumstances be shaken. A loosening of this price anchor would lead to further overspending of the health insurance companies."These will probably also be reflected in a higher contribution rate," said Steimle. According to her own statements, the TK advocates that the prices of medicines that could not prove their additional benefit remain secret, at least in parts, until proof of the added benefit, and thus comes a bit towards the industry.
Avoiding unnecessary market withdrawals
The goal is to avoid unnecessary market withdrawals to the detriment of the patient with the help of the secret discount. For a public discount in Germany costs the industry also in other countries money, because the prices abroad are often based on the German market. Although many patients may already be prepared for the new drug, the manufacturers are withdrawing the drug from the market in Germany due to the low price. TK has yet another point of criticism: "We see no sense in the fact that the pharmaceutical companies in the first twelve months, the price of a new drug may set themselves and the health insurance must pay - regardless of whether it later can prove an added benefit or not, This merely increases the incentive for manufacturers to generate as much turnover as possible, ie large numbers of patients, in the first year after market access, "explained Steimle.(ad)