Drug exams do not create savings

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The savings target of the drug tests is likely to be missed

Expenditures for pharmaceuticals have risen continuously in recent years, which is not only a major challenge for the health system as a whole, but also has given rise to criticism of the price policy of pharmaceutical manufacturers. The examination of new medicinal products by the Federal Joint Committee (G-BA), composed of representatives of the medical profession, the health insurance company and the hospitals, is intended to remedy this.

From now on, the G-BA - as the highest body in this country for joint self-administration in the healthcare sector - will review all new medicinal products for their added benefit in order to determine whether the corresponding medicinal products actually justify an increased price or not. In this way, the price policy of pharmaceutical manufacturers, which has been critically assessed by many sides, is to be stopped and an increased price will only be possible if there is real progress. The federal government, consisting of the CDU, CSU and FDP, hoped to save billions in pharmaceutical expenses after the decision for the additional review, but the top body of self-administration in the health sector is now putting a damper on these expectations: the coalition's savings target will probably not be achieved in the near future.

Hoped-for savings in the health care system are a long time coming Almost a year has passed since the Federal Government created a new basis for the future of the health care system with its health reform decisions. The most important goal was to absorb the cost explosion to a certain extent and to put a stop to the drug expenditure, which had been increasing for years. For this, the pharmaceutical companies demanded a compulsory discount of 16 percent, which will decrease again to six percent from the end of 2013, and decided to examine the added benefit of new drugs as the basis for setting prices. From now on, higher prices for new drugs should only be reimbursed by health insurance companies if there is a recognizable additional benefit compared to comparable therapies, the decision was made almost a year ago. A preliminary assessment of the new approach is expected to be presented by the Federal Joint Committee later this year, the chairman of the top committee, Rainer Hess, told the news agency "dpa". However, the hoped-for savings will probably not be achieved in the foreseeable future, the chairman of the G-BA continued.

Evaluation of medicinal products as the basis for price negotiations When reviewing new medicinal products, the self-governing body of clinics, doctors and health insurance companies uses the reports of the manufacturers to determine whether the new medicinal products actually have an added value compared to previous treatment methods and thus justify a higher price. From the beginning of next year, the health insurance companies should then negotiate the price of the pharmaceuticals with the pharmaceutical manufacturers themselves based on the G-BA assessment. Only medications that bring about an improvement over conventional therapies in the interests of patients are therefore paid higher by the health insurance companies. The federal government hopes to save billions in pharmaceuticals costs. Rainer Hess believes that the cost savings of around two billion euros annually announced by politicians are only possible if the medicinal products that have been on the market for some time are also included in the review. However, "it is currently not possible to estimate with certainty when a significant proportion of active substances will be subjected to a new assessment," the G-BA chairman told the news agency "dpa". Whether the spending of statutory health insurance for drugs, which has been exploding for years, can be slowed down with the new regulation, will depend in the future largely on price negotiations based on the additional benefit. However, the figures for 2011 seem like a slight glimmer at the end of the tunnel, because for the first time drug expenditure is expected to decrease this year. In the first half of the year, the expenditure volume fell by 6.3 percent to around 15 billion euros, and the federal government is also expecting a significant reduction in pharmaceutical expenditure for the year as a whole. The savings are largely due to the aforementioned 16 percent compulsory discount from pharmaceutical manufacturers.

Pharmaceutical companies defend themselves against the new regulation The pharmaceutical industry is still massively defending itself against the decisions of politicians and the Association of Researching Pharmaceutical Manufacturers (vfa) expressly warned that promising, innovative medicines in this country will no longer be available to patients in the future immediately after their approval, since the price negotiations are to be completed for the time being. As vfa managing director Birgit Fischer explained to “dpa”, “first experiences give cause for concern.” The pharmaceutical companies see patient care in danger here and urge them to take sufficient account of the research, but at the same time emphasize that in principle there is nothing against them Evaluation of the medicinal products should be used. For the central association of statutory health insurers, the reasoning of the pharmaceutical manufacturers is incomprehensible and the association spokesman Florian Lanz told dpa: "Nobody should be unsettled by the pharmaceutical industry and believe the occasional prophecies of doom that real innovations will no longer come onto the German market. “The concerns of the pharmaceutical companies mentioned are pure mood-raising.

The chairman of the drug commission of the medical profession, Wolf-Dieter Ludwig, does not go that far, but Ludwig also emphasized the surplus of active ingredients and medicines currently prevailing in this country. For example, "around 20,000 prescription drugs with around 2,000 active ingredients are approved in Germany," but 300 to 500 active ingredients would suffice, Ludwig told the "dpa". This multitude of medications does not bring progress and is part of a cost-driving price policy, according to the G-BA experts' criticism. Therefore, the new valuation methods would lead to falling prices in the long run, however, according to Wolf-Dieter Ludwig, it will take a few years before "before industrial rethinking and better-effective medicines come onto the market." (Fp)

Read on:
Health insurance companies: record value for pharmaceutical expenses
Billions of dollars in pharmaceuticals
Co-payments for pharmaceuticals rose again
Pharmaceutical expenses explode
Co-payments for pharmaceuticals rose again
Health insurance companies will increase drug budgets from 2011

Image: Andreas Morlok / pixelio.de

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