Pharma discounts PKV insured benefit

According to the will of the Federal Minister of Health, private health insurance (PKV) should receive a significantly higher share of pharmaceutical discounts in future than previously assumed. Above all, the 8.8 million private health insured persons could benefit from these new regulations, because the rebates are intended to avoid premiums for insurance policies.

If it goes by the will of the Federal Government, the negotiated pharmacy discounts for the statutory health insurance will apply in the future for private health insurance. In addition to the discounts, there will be a manufacturer discount of 16 percent, which was negotiated on the first of August by the Central Association of Statutory Health Insurance Funds (GKV). According to coalition circles, the insured persons themselves should benefit, because the discount contracts are designed to prevent an increase in insurance premiums. Thus, the black-yellow coalition announced that it should be ensured "that the relief from the pharmaceutical rebate all insured, including the privately insured, actually benefit".

The Federal Ministry of Health emphasizes that this is not a regulation to strengthen the PKV companies, but a relief for the insured. However, PKV has in the past repeatedly urged the government to also benefit from the pharmaceutical rebates. So it seems that the intercessions to the Federal Government now had a visible success. The new regulations are very likely to be implemented as part of the healthcare reform.

Furthermore, in the context of the reform, the statutory health insurance funds for each new drug price negotiations with the respective pharmaceutical manufacturers. However, these are drugs that have been found to add value to patients compared to other drugs. From this new regulation and from the producer discount, which was increased by 16 per cent on the first of August, which is linked with a price stop and was limited until the end of 2013, the private health insurance company should benefit as well. The discount applies to drugs for which no fixed amount has been agreed.

A participation of the PKV in future discount negotiations is planned; However, the association of private health insurance criticizes the discount specifications, as they are to be done "in behavior". "Co-determination" would look different, the association said. Because the price negotiations are still led by the umbrella association of the GKV. However, the PKV would rather enter into negotiations with pharmaceutical manufacturers themselves and negotiate correspondingly economically oriented contracts.

Discount for PKV no promotion of companies
The private health insurances should be allowed to use the savings "exclusively for the avoidance or limitation of premium increases or for the premium reduction", let the coalition announce. From a policy in the sense of the PKV could be no question, since it is superficially about the interests of all insured.

Criticism of the inclusion of discount contracts for private health insurance
The statutory funds are not at all excited by the innovations and expressed sharp criticism. The reforms are one „state support package“, Florian Lanz from the GKV Verband. Lanz sees it as „amazing“ that the PKV can no longer do without the negotiating skills of the GKV. On the one hand, private health insurance does not have to cover the solidarity principle of health insurance, but on the other hand, they still want to profit from the rebate provisions.

The Association of Research-Based Drug Manufacturers (VfA) sees its skins swimming away. Due to the planned discounts, it is expected there with annual sales losses of around 500 million euros. The association also criticizes the fact that private health insurance as a business enterprise now benefits from state regulations, even though it does not have to comply with the solidarity principle of the health service. Because in the PKV are superficially good earners and officials insured, which have more financial resources.

PKV benefits greatly from the health care reform
In conclusion, it can be stated that the black-yellow coalition wants to favor private health insurers enormously. Because the discounts are not the only changes in the sense of PKV. From next year, for example, it should be made easier for employees to switch to private health insurance. Instead of the three-year rule, a one-year rule will come into force. This means that an employee with a gross salary of at least € 4162.50 a month after one year can decide whether to remain in the GKV or to switch to private health insurance. Especially for young and childless insured, a change could be worthwhile. However, as a result, the statutory funds are losing numerous good contributors. This could be another financial problem for the SHI. How the regulations look in detail and when they are implemented is unknown. However, it can be assumed that they will be implemented as part of the health care reform. A draft bill is currently being drafted by the Ministry of Health. (sb, 09.10.2010)

Also read:
Medicare discounts also for the PKV
Private health insurance: Worth a change?
Save on private health insurance
PKV: services and quality a change reason?
Federal Government: billions for the PKV

Picture credits: Benjamin Klack