Drug tests do not create savings

Saving target of the drug trials is likely to be missed

13/11/2011

Expenditure on medicines has increased steadily in recent years, which is not only a major challenge for the health care system as a whole, but has also given rise to criticism of pharmaceutical manufacturers' pricing policies. The examination of new drugs by the Federal Joint Committee (G-BA), staffed by representatives of the medical profession, the health insurance fund and the hospitals, is intended to remedy this situation.

From now on, all new medicines will be assessed for added value by the G-BA - the country's highest body of collective self-government in the health sector - to determine whether or not the drugs in question actually justify an increased price. In this way, the price policy of the pharmaceutical manufacturers critically judged by many sides should be stopped and only with real progress a higher price should be possible. The Federal Government of the CDU, CSU and FDP hoped after the decision for the additional test billions in savings on pharmaceutical spending, but the leading body of self-government in health care is now these expectations a damper: The savings target of the coalition will probably not be achieved in the near future.

Expected savings in the healthcare system are coming up
Almost a year has passed since the federal government created a new foundation for the future of the healthcare system with its decisions on health care reform. The most important goal was to absorb the cost explosion to some extent and to put a stop to the years of increasing drug expenditure. For this, a mandatory rebate of 16 percent was demanded by the pharmaceutical companies, which, however, from the end of 2013 will reduce again to six percent, and decided to consider the added value of new drugs as a basis for pricing. Henceforth, higher prices of new drugs should be reimbursed by the health insurance companies only with recognizable added benefit over comparable therapies, so the decision just under a year ago. An initial assessment of the new approach is expected later this year submitted by the Joint Federal Committee, said now the chairman of the executive committee, Rainer Hess, to the news agency „dpa“. However, the hoped-for savings will probably not be achieved in the foreseeable future, according to the chairman of the G-BA.

Evaluation of drugs as a basis for price negotiations
The self-governing body of clinics, physicians and health insurers, when testing new medicines based on manufacturers' reports, determines whether the new medicines actually add value over existing treatments and thus justify a higher price. From the beginning of next year, the health insurances should then negotiate the price of the pharmaceuticals themselves with the pharmaceutical manufacturers on the basis of the G-BA assessment. Only medications that bring about improvements in the patients' sense compared to conventional therapies are therefore paid higher by the health insurance funds. The federal government hopes to save billions on pharmaceuticals. However, the cost savings of around two billion euros announced annually by the government are, according to Rainer Hess, only possible if the drugs, which have been on the market for some time, are also included in the review. However, let yourself be „at present, it is not certain when a significant proportion of active substances will be reassessed“, the G-BA chairman told the news agency „dpa“. Whether the expenditures of the legal health insurance for medicines, which have been exploding for years, can be slowed down with the new regulation, depends in the future substantially on the price negotiations based on the added benefit. However, the figures for the year 2011 seem like a slight shimmer at the end of the tunnel, because for the first time, drug spending is expected to fall this year. In the first half of the year, spending volume fell by 6.3 percent to around 15 billion euros, and the Federal Government expects a significant reduction in pharmaceutical spending for the year as a whole. Most of the savings can be attributed to the aforementioned mandatory discount of 16 percent by pharmaceutical manufacturers.

Pharmaceutical companies defend themselves against the new regulation
The pharmaceutical industry is still fighting hard against the decisions of the policy and the Association of Research-based drug manufacturers (vfa) warned against the fact that promising, innovative medicines in this country would not be available to patients immediately after their approval in the future, as initially the price negotiations to an end to lead. Like the vfa managing director Birgit Fischer opposite the „dpa“ explained, give „the first experiences cause for concern.“ The pharmaceutical companies see the patient care in danger here and urge to consider the research sufficiently, but at the same time emphasize that in principle there is nothing against the evaluation of the drug. For the top federation of the legal health insurance the argumentation of the pharmaceutical manufacturers is not comprehensible and the federation speaker Florian Lanz explained to the dpa: „No one should let themselves be unsettled by the pharmaceutical industry and believe the occasional doomsay that genuine innovations are no longer coming to the German market.“ The mentioned concerns of the pharmaceutical companies are pure sentiment.

The chairman of the pharmaceutical commission of the medical profession, Wolf-Dieter Ludwig, does not go quite that far, but Ludwig also emphasized the surplus currently prevailing in Germany in terms of active ingredients and pharmaceuticals. So be „In Germany, about 20,000 prescription drugs with about 2,000 active ingredients approved“, However, 300 to 500 active ingredients would be sufficient, Ludwig explained to the „dpa“. This multitude of medicines brings no progress and is part of a cost-pushing price policy, so the criticism of the experts of the G-BA. Therefore, the new valuation methods would lead in the long run to falling prices, but in the opinion of Wolf-Dieter Ludwig still some years pass, „before a rethinking of the industry starts and more effective drugs come to the market.“ (Fp)

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Picture: Andreas Morlok