Medicines: Health insurers will soon pay more

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Pharmaceuticals: Statutory insured persons will pay more in the future.

(03.09.2010) The German Pharmacists Association (ABDA) announces that from this month only 5,524 of the approximately 8,400 over-the-counter prescription-only medicines can be dispensed without a cost contribution from customers. The reason: the statutory health insurance companies have to reduce their costs.

Since September 1st, insured persons have to make a contribution of 10 percent, but a minimum of 5 and a maximum of 10 euros, to the cost of the drug for almost 3000 medications that were previously free of payment. The funds received are passed on directly from the pharmacies to the insurance companies. According to the ABDA, 1.7 billion were already paid to statutory insurance companies in 2009 with the higher number of overpaid medicines.

Pharmaceuticals whose price is 30 percent below the fixed amount determined by statutory insurance are exempt from co-payment. The fixed amount indicates the maximum amount that the insurance companies are willing to pay for a preparation. For example, insurance companies have now reduced the fixed amount for around 20 drug groups, with the additional payment limits for 18 groups changing. As a result, the majority of the preparations will be subject to contributions in the future. If the manufacturers do not react with cost reductions, as officially hoped for by the statutory insurance companies, customers will pay more from now on. Insurance companies, on the other hand, can expect savings of around 450 million euros. A large number of antibiotics, gastrointestinal and circulatory agents are affected, a spokesman for the Federal Association of German Pharmacist Associations told The fixed amount regulation currently comprises around 30,300 drugs.

The Federal Ministry of Health recommends that those affected get information about alternative medicines free of charge and, if necessary, change. In addition, the spokesman for the Ministry of Health, Christian Lipicki, emphasized that in the past producers had always corrected their prices after such measures. Lipicki also pointed out that the additional payments are capped at two percent of the income - for chronically ill people at one percent.

However, due to the reduced fixed amounts, it can also happen that those insured by law have to make so-called additional payments. Because with preparations whose price is above the fixed amount, customers have to pay the difference out of their own pockets. And since long not all manufacturers react with price reductions, there are sometimes sums of more than 100 euros that insured persons can pay for required medicines themselves. According to the industry service pharmacy Adhoc, manufacturers such as AstraZeneca, Bayer, Merck or Pfizer will not lower the prices of numerous preparations. Mostly original manufacturers are defending themselves against the control instruments of insurance companies. The generics manufacturers, on the other hand, largely adjust their prices. (fp)

Also read:
Medicines: drug prices rise

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