Criticism of drug prices: Controversial indulgence with the pharmaceutical industry
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| drug-prices |
The authors of the Drug Prescription Report sharply go to court with the highest body in the healthcare sector: it wants to give away hundreds of millions of euros to insured persons to the pharmaceutical industry. But the G-BA boss Hecken defended his plans.
Actually, should prevail before the federal election health policy peace. But the new prescription of medicinal products (AVR) raises unpleasant questions: The authors criticize in unusually sharp ways that the Federal Joint Committee (G-BA) "gives away significant cost savings".
Because the head of this highest self-government body in the health service, Josef Hecken, has spoken out for a deal with the pharmaceutical industry. For the payment of about 1.5 billion euros per year, the G-BA would be prepared to waive the price regulation for old drugs. The health insurance companies also consider this to be "pragmatic", the Federal Ministry of Health confirms that "talks are already at the technical level". AVR's main author Ulrich Schwabe, on the other hand, says that "without the deal, much greater savings can be achieved".
Already in 2010, the current federal government decided on the Amending of the Pharmaceutical Market (Amnog). It allows the G-BA to assess the benefits of older preparations in the so-called inventory market. Then the prices are negotiated (see graphic).
Germany has the highest prices internationally
Negotiation should be based on the drug prices of other EU countries. The AVR authors, therefore, see enormous savings potential in the existing market, because Germany has the highest international prices. "With the first five top-selling medicines alone, the exemplary price comparison with French medicines can be used to calculate savings of 414 million euros," writes Schwabe.
But the G-BA had decided instead about in April, to evaluate rheumatism, but just the highest sales product Humira not considered. A pack of Humira costs in Germany 4554 euros, in France, however, only 3005 euros.
"There is no plausible reason why this drug of the existing market was not called for a benefit assessment," criticizes Schwabe. Thus the chance is given to save with legally insured persons in the next five years 600 million euro. Josef Hecken knows that this is not a failure of the G-BA, but rather lies "in the method and system of the Amnog". An added-value assessment of a medicinal product intended as an ACT is systematically excluded from such an assessment.
One reason could be that hedges want to get rid of the evaluation of old drugs. In the middle of the summer hole, he made a suggestion that suggests just that. The "Ärztezeitung" reported in July on an event in Deggendorf, where he had said that he "in principle waive the benefit assessment of the existing market and extend the price moratorium for two years."
This price moratorium, which was invented by the black and yellow government in 2010, forces the pharmaceutical industry to grant the health insurance companies a discount of 16 percent on drug prices. Thus, the statutory health insurance (SHI) save, according to the GKV-Spitzenverbands annually 1.5 billion euros. However, the savings in the existing market are significantly higher than 1.5 billion euros, say the AVR authors. If Hecken now proposes to extend the 16-percent discount beyond the year 2013 and to waive the evaluation of old drugs, he will give away millions of euros of the health insurance.
From the Heckens point of view, the indulgence trade has the advantage of saving a lot of work and legal disputes with pharmaceutical companies. Finally, companies usually challenge any unfavorable decision in court. His predecessor, the lawyer Rainer Hess, liked these arguments. Hedges, only in office for a year, on the other hand, comes from politics. Until 2008 he was CDU Minister of Health in Saarland, then State Secretary in Berlin. He is used to solving conflicts with compromises.
Heckens proposal has apparently great chances to be realized - if only after the general election. At the request of SPIEGEL ONLINE, the Ministry of Health announces: "We will talk in due course about how the rebate will be continued," says Ministry spokesman Roland Jopp.
Jens Spahn, health spokesman for the CDU / CSU parliamentary group and one of the candidates for post-election health minister, says only that he wants to "hold on to" the assessment of the stock market. "In the end, it is crucial that we do not pay for medicines more expensive than it should be in the interests of the insured," says Spahn. Florian Lanz, the spokesman for the association of health insurances, says to Heckens indulgence: "We think this as a pragmatic and unbureaucratic way imaginable."
On request, the G-BA boss explains: "Sympathy for this way can be found in many pharmaceutical companies." Previously, the "Ärztezeitung" had quoted him with the remark that he had gained from discussions with the companies the "clear and unambiguous impression" that the economy planning security is more important than the uncertainty factor of the inventory market appeal.
If you look around in the pharmaceutical industry, you hear something completely different: "The absolute majority of the industry does not want this deal," says an insider. A waiver of the assessment of the inventory market would only benefit those companies that have overpriced older products on the market. The compulsory rebate, on the other hand, affects all companies equally. "This is a political game by Mr. Hecken, who wants to get rid of the overload of his authority."