Structural Problems, Not Pharmaceuticals, Drive health Insurance Deficits
Berlin (ots) – The Federal Audit Office (BRH) recently examined the financial advancement of statutory health insurance (GKV) and concluded that structural problems are the root cause of the lack of financial reserves among health insurance companies. The Federal Association of Pharmaceutical industry (BPI) agrees with this assessment but strongly disputes a key proposal: the BRH’s suggestion to rely on short-term savings based on the Council of Experts (SVR) report.
“Undermining the pricing structure for pharmaceuticals doesn’t just weaken pharmaceutical companies; it ignores the economic consequences and jeopardizes patient care,” warns dr.Kai Joachimsen, General manager of the BPI.”The search for errors and solutions to the GKV’s financial woes must begin elsewhere.”
Lasting GKV Financing Reform is overdue
“A prime example of flawed structural financing is the healthcare of citizens’ dependents – it burdens the GKV with approximately ten billion euros annually. This is a systemic issue, currently funded by insured individuals and employers. As Federal Minister of Health Nina Warken rightly recognizes, it’s crucial to relieve the GKV of these costs through tax financing,” emphasizes Joachimsen. “Rather, we’re seeing only short-term emergency measures like repayable loans, which further strain the system.”
Expenditure development: A Matter of Context
The BRH highlights rising expenditures on patent-protected drugs. Though, the BPI points out:
“Even if highly innovative therapies initially appear expensive, they ultimately relieve the healthcare system by preventing severe disease progression or alleviating suffering. Furthermore, our industry has consistently contributed to stabilizing the GKV for years. Yet, the impression persists that pharmaceuticals are the primary problem – despite their cost share remaining constant at around 35% of total statutory health insurance expenses, even after accounting for all trade levels, which now represent eleven percent through price instruments.”
Specifically, the BPI highlights the following savings mechanisms:
Discount Contracts: Health insurers benefit from nearly six billion euros in annual savings. Reimbursement Amounts (AMNOG): Savings have increased from 144 million euros in 2013 to 7.3 billion euros in 2024.
* Forced Discounts: The industry paid an additional 2.8 billion euros in 2023, with projections exceeding that amount in 2024.
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