Pharmacy discounts Pharmacists quarrel with cash registers

The dispute between the health insurance companies and pharmacies for drug discounts is getting worse

01/07/2011

The dispute between the pharmacies and the statutory health insurance (GKV) on the implementation of the new drug discount law is coming to a head: the GKV warn patients against turning over overpriced drugs, the pharmacists accuse the GKV misinformation and disinformation.

Since 1 January, the new drug discount law passed in the context of health care reform has made it possible, among other things, for patients to demand more expensive drugs with the same active ingredients instead of discount medicines. Among the pharmacies and the statutory health insurance (GKV), however, there is disagreement over what drugs the patients in the pharmacy actually ask and what procedure for the reimbursement of the cost of extra drugs is.

With the coming into force of the law for the reorganization of the drug market (AMNOG) patients can choose since the beginning of the pharmacy rather than the discount drugs an equivalent drug from another manufacturer, if the drug and quantity correspond to their prescription and the doctor has no objection to the replacement. In this case, the patients pay the full price of the drug directly in the pharmacy, receive a receipt and submit it to their health insurance. The health insurance company then decides what sum the patient will receive when reimbursed. However, the GKV take over only the amount that would have cost the originally prescribed, discounted drug. The remaining costs are to be borne by the patients, whereby not inconsiderable sums may be incurred here, as the chairman of the German BKK, Achim Kolanoski, emphasized. Therefore, the affected should in any case be informed in advance about the possible additional costs. But even this does not always seem easy.

For example, Thomas Ballast, chairman of the association of alternative health insurance companies (vdek), advised the patient in a press release on Tuesday to ask about possible additional expenses in the pharmacy and not to be persuaded to overpriced medicines. The chairman of the German Pharmacy Association DAV, Fritz Becker, stated, however, that the pharmacies can give no information about the possible additional costs, since most SHI did not even calculate the administrative flat rates as an important factor of cost accounting. Becker threw the chair of the vdek „Incorrect and disinformation“ in front. „Again, the coffers let their insured down“, Becker continues. „Patients come to the pharmacies badly or wrongly informed and must be informed by us about the facts“, explained the DAV chairman „Because the coffers keep their contracts a secret, the lack of transparency we have been criticizing for a long time now turns into chaos in the long term. Once again, the bureaucratic insanity must drain the patients and the pharmacies“, Becker emphasized on behalf of the DAV. The situation was additionally complicated by the fact that many drug manufacturers have recorded false information on drug changes in the pharmacy computer, explained Becker and therefore demanded: „No transparency and irresponsibility. We need supply security again - instead of rip-off.“

In fact, there is an increasing level of incomprehension among the insured, they do not feel that they are sufficiently informed about the change and its consequences, said the chairman of the DAV. In pharmacies, this is reflected in increased demands and an increased need for advice from patients, which in turn brings longer waiting times for all pharmacy customers. „For the patients, this is a black hole, because they do not know what kind of stress they will have“, criticized Becker. „And it is unbelievable that the health insurances want to let the insurers pay for this chaos, while pharmacists take over the work of the health insurances and have had to deduct additional discounts to the coffers since 1 January 2011“, so the further criticism of the DAV chairman. In the end, the victims were once again the patients, because they were on the one hand insufficiently informed about their options and the corresponding additional costs, on the other hand, they must take in the pharmacies significantly longer waiting periods, concluded Becker.

The chairman of vdek Thomas Ballast countered, however: „The actual profiteer of the additional cost procedure is the dispensing pharmacy, since the requested medication is treated like a private prescription“ and the negotiated pharmacy and manufacturer discounts provided by law thus no longer apply. Achim Kolanoski, chairman of the German BKK, however, advised the insured not to ask for an alternative to the cheaper drugs, because these are only more expensive and would not bring medical added value. (Fp)

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Picture: siepmannH, Pixelio.de.