Health care reform: The pharmaceutical industry benefits again
The black and yellow government coalition continues to distribute gifts to the pharmaceutical industry. So far, the Federal Joint Committee (G-BA) has been able to exclude drugs from reimbursement by the health insurance companies. In the future, according to the will of the CDU / CSU and FDP, such a decision will only be possible if the G-BA can clearly prove the inappropriateness of the drug.
Medicines are tested and approved in Germany by the Federal Institute for Drugs and Medical Devices (BfArM). However, the G-BA was then able to declare drugs not marketable and reimbursable if they offered no additional benefit for the patient compared with drugs with the same active ingredients. The G-BA has so far only made use of the option once and excluded a drug from reimbursement by the health insurances, but in the opinion of the Chairman of the Federal Joint Committee, Rainer Hess, the detailed benefit assessment of drugs by the self-administration must still be preserved.
"The fact that the Federal Joint Committee should determine the inappropriateness of a drug at the time of approval completely misses the goal of a benefit assessment," explained Rainer Hess. Studies and reports on the evaluation of drugs are usually not available before approval, as no company prepares them voluntarily. "In the interest of the patient (therefore) the planned reversal of the burden of proof must be dispensed with and the detailed benefit assessment of drugs must be retained," emphasized Hess. The G-BA is to provide the proof of inappropriateness required by the federal government with the help of studies by the relevant pharmaceutical company or the Institute for Quality and Efficiency in Health Care (IQWIG).
The planned approach is met with sharp criticism not only from the opposition but also from the self-administration of doctors and health insurers. The fact that the basis for the change in the law is the opinion of a law firm on behalf of the Association of Researching Pharmaceutical Companies (VFA), as reported by "Spiegel", also makes the accusation of clientele politics louder again. The Federal Ministry of Health promptly sought clarification and stated that the planned change is intended to create "more clarity and greater legal certainty" and that the G-BA will only have to underpin its decision with scientific evidence in future. "That also helps the Federal Joint Committee," said a spokesman for the ministry. The fact that the suspicion of clientele politics can still not be dispelled is also due to the planned abolition of the cost reimbursement for numerous dietary supplements Health insurance paid. (Fp)
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