Growth in spending on drug reimbursement by Germany's statutory health funds slowed to 1% in 2010, a sharp downturn on the 4.8% advance seen the year before, according to new industry data.
The health funds spent some 32 billion euros on drug reimbursement (not including vaccines) last year. The reasons behind the sharp fall in spending growth are reportedly Germany's three-year freeze on drug prices and the increase in discounts from 6% to 16% imposed in August 2010 on innovative medicines which are reimbursed by the funds and not covered by the country's internal reference pricing system.
Spending on drug reimbursement grew more slowly in 2010 than that for health care in Germany as a whole, which rose 2.9% to 180.7 billion euros, and drug reimbursement accounted for 17.7% of overall health care spending during the year, down from a share of 19% in 2009, says the report, which is published by the scientific institute of Germany's largest health fund, the Allegemeine Ostkrankenkasse (AOK).
However, the report also estimates that utilising European reference pricing could have saved the German drugs bill as much as 12.1 billion euros last year, and points to the continuing high prices of medicines in Germany compared to levels in Sweden and the UK. German prices of top-selling generic drugs are 90% higher, on average, than in the UK, and for some generic or patent-expired products the prices are as much as 211.7% more, it says, estimating that if UK prices for leading generics had applied in Germany during the year, a further 3.3 billion euros could have been saved.
The report also points out that while value-added tax (VAT) is charged on medicines in Germany, this is not the case in the UK.
Meantime, the German federal health ministry has approved plans for the establishment of a national catalogue of medicines.
The plan's sponsors - the national association of statutory health insurance physicians (KBV) and the pharmacy association (ABDA) - forecast that the catalogue, which would list cost-effective medicines by their active ingredient, could produce savings of around 2.1 billion euros by 2014.
Analysts at IHS Global Insight point out that the medication catalogue should not be confused with proposals for a positive reimbursement list which has long been under discussion in Germany. "The catalogue would serve as a guideline but would not be binding for doctors, in contrast with positive list," they note, but also suggest that as the catalogue is likely to "rationalise" prescribing in both therapeutic and economic terms, it could be expected to produce savings for the health funds.
Plans for the catalogue will now go forward for discussion in parliament. The initiative will be tested in pilot projects around the country, and could be introduced by next January.
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