Eligibility of medicines



We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

The eligibility of expenses for pharmaceuticals was not limited to the fixed amounts of the statutory health insurance under the old federal state aid law that applied until September 2012. This has to be decided by the Federal Administrative Court. The old law had no legal basis for such a limitation.

The plaintiffs are beneficiaries of pensions and, in the event of illness, are entitled to civil servants' benefits in the amount of 70% of the eligible expenses. The defendant only granted the plaintiffs for medication aid up to the amount specified in the statutory health insurance law. The plaintiffs wanted to assert higher aid based on the pharmacy sales price.

The lower courts disagreed as to whether it was lawful to limit the eligibility of drug expenditure to fixed amounts. VGH Kassel and VGH Mannheim denied this. They granted the plaintiffs' request. In contrast, the OVG Schleswig affirmed the legality of the restriction.

BVerwG: No legal basis for limitation to fixed amounts The BVerwG has now confirmed that the limitation of the eligibility of expenses for pharmaceuticals to fixed amounts according to old law was illegal due to the lack of a legal basis. Neither the Federal Aid Ordinance (BBhV) in the version dated February 13, 2009, nor the general administrative regulation issued on February 14, 2009, had stipulated certain fixed amounts for medicinal products. Section 22 (3) BBhV a. F. had only authorized the Federal Ministry of the Interior to fix fixed amounts as upper limits for the eligibility of drug expenditure in administrative regulations. The general administrative regulation had regulated further details of a corresponding fixed amount provision without making such a decision itself.

The new Section 22 (3) BBhV now provides for an explicit limitation of the eligibility of expenses for pharmaceuticals to fixed amounts. (Ref .: BVerwG 5 C 2.12, BVerwG 4.12 and BVerwG 6.12)

Image: HHS / pixelio.de

Author and source information


Video: Presenting Clinical Pharmacology Information in Prescription Drug Labeling Jun. 19, 2017


Previous Article

Vegetarian diet protects against heart disease

Next Article

Practice for classic homeopathy