Billions in pharmaceuticals

Medicinal Product Report 2011: Drug cost reducible by more than eight billion

16/09/2011

The healthcare system could save a quarter of the cost of medicines, according to the results of the AOK-funded project „Remedies Report 2011“. The costs of the statutory health insurance for drug prescriptions could therefore be reduced by about eight billion euros per year - with the same medical care of patients.

As the AOK Vice President Jürgen Graalmann explained, the „Remedies Report 2011“ revealed a significant savings potential in the area of ​​pharmaceutical expenditures. Still give „there is still air in the prices“, stressed Graalmann. According to the report, spending on medicines could be reduced by 27 percent. In other words, this means that currently more than a quarter of drug expenditure is wasted money. Eight billion euros could be saved in the statutory health insurance (SHI), without the medical care would be affected, according to the results of the drug prescription report in relation to the figures of the past year. The Federal Association of the Pharmaceutical Industry (BPI) responded immediately and stated, „The AOK drug prescription report ignores reality.“

Numerous savings options for drug expenditures
In the 2011 Pharmacopoeia Report, 791 million statutory health insurance contributions from the previous year were taken into account and evaluated by the AOK's Scientific Institute. In their calculations, the experts come to the conclusion that the drug costs could already be reduced by 4.1 billion euros, if the prices for expensive, patent-protected drugs in this country would be reduced to British level. As an example, the drug prescription report mentions the arthritis drug Humira, which costs 4,393 euros per pack in Germany and is thus almost twice as expensive as in the United Kingdom. Additional savings potential results according to the report in the field of generics. In the generics produced as copycat drugs after the expiry of patent protection, the Drug Regulations Report provides savings potential of 3.3 billion euros if British prices were used. The Heidelberg pharmacologist and publisher of the report, Ulrich Schwabe, explained that the leading German generics are on average 90 percent more expensive than in the United Kingdom. For individual generics fall in this country even ten times the British price, and correspondingly large is the potential for savings, said the expert.

Measures of the drug savings package show first success
However, the massive savings do not only result in comparison with British drug prices, but also when looking at the preparations that can be sold in Germany alone. Based on the German prices could be saved by the consequent prescription of inexpensive generics and the renouncement of expensive patent-protected analogue preparations 4.7 billion euro, thus the statement of the medicament regulation report. Under analogue preparations new expensive medicines are to be understood, compared to already introduced cheaper preparations bring no significant added benefit. However, initial successes in the reduction of pharmaceutical expenditures have already occurred through the drug-saving package of the black and yellow federal government. Measures such as the price freeze on pharmaceuticals imposed by the Federal Minister of Health in August 2010 and the mandatory discounts of 16 percent imposed on the pharmaceutical industry by the year 2013 have had a significant impact and contributed to a slight decrease in pharmaceutical spending in the first half of 2011. Overall, the number of prescriptions remained largely constant in 2010 compared to the previous year, and drug expenditures rose by only one percent, according to the Drug Prescription Report.

In the future, the selling prices of patented medicines between the health insurances and the pharmaceutical industry should be negotiated directly in order to ensure a price level commensurate with the benefit. It is also intended to ensure in this way that new preparations actually bring about a significant added benefit for the patients. If the pharmaceutical manufacturers and the statutory health insurance companies can not agree, the selling price will be determined by an arbitration board. These legal changes are one „bold step“ The Federal Government and act preventatively against overpriced patented analogue preparations, but at the same time leave enough room for real innovation, stressed the AOK Vice President Jürgen Graalmann. The fact that the pharmaceutical manufacturers have to prove the added benefit of their drugs in advance has already been shown to affect two preparations in recent months. The one manufacturer then withdrew its product, the other had to settle for significantly lower prices.

Medication catalog as the next step
As announced last week, the black-yellow federal government with an amendment to the supply structure law, the establishment of a medication catalog, which prescribes certain drugs for the treatment of patients as a kind of positive list, taking drugs that are not listed in the catalog, in the future no consideration in the usual ordinances should find more. In the medical profession, this proposal met with clear approval, whereby the President of the German Medical Association, Frank Ulrich Montgomery, promises not only an improved quality of care but also greater economic efficiency from the planned medication catalog. In a pilot project, this medication catalog developed by the National Association of Statutory Health Insurance Physicians and the Federal Association of German Pharmacists Associations (ABDA) will now be tested. Doctors prescribe the substances from the positive list and the pharmacists then determine the appropriate drug.

Pharmaceutical manufacturers reject planned changes
While the pharmaceutical manufacturers were already skeptical about the changes made so far to the drug savings package, the planned medication catalog is met with massive rejection. The BPI has this as „standardized cookbook medicine“ sharply criticized and at the same time demanded by the physicians not to give their therapeutic freedom lightly out of hand. In the background of the drastic criticism should, however, according to industry experts also financial interests, because some manufacturers are threatened with significant revenue losses. Also the current criticism of the AOK meets therefore with the pharmaceutical industry a sensitive nerve. While the figures in the Drug Prescription Report are hardly questionable, the Federation of the Pharmaceutical Industry (BPI) said that the AOK drug prescription report ignores reality. The managing director of the pharmaceutical association vfa, Birgit Fischer added that there is an urgent need for an intensive debate, „how to reconcile innovation and sustainable financing“. (Fp)

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Picture: Andreas Morlok