The statutory health insurance (GKV) industry association, GKV-Spitzenverband, has warned against burdening the public health care system with an estimated 1.3 billion euros due to the implementation of a “location clause” designed for pharmaceutical producers. A spokesperson for the association stated to the “Rheinische Post” that if the GKV were forced to cover the costs associated with this location clause, it would completely undermine the reformed spirit of the GKV package recently approved by the Bundestag.
The proposed location clause aims to grant pharmaceutical companies exemptions from an additional manufacturer rebate that is scheduled to take effect next year. Starting January 1st, pharmaceutical companies are generally required to pay a total deduction of 15.5% on patented medicines, serving as a contribution toward savings in statutory health insurance. A special committee was established to draft this clause, and it is due to present a report next Tuesday.
However, considerable disagreement exists regarding how the exceptions should be financed. Sources within the GKV-Spitzenverband reportedly informed the “Rheinische Post” that if the committee’s suggestions are adopted in their current form, they could increase the GKV’s financial burden by 1.3 billion euros.
While the initially approved savings package included an increase in manufacturer rebates by 8.5 percentage points, which was projected to yield savings of 4.1 billion euros, the actual savings potential has been reduced due to specific exemptions already legislated for certain medicines, such as generics, children’s medicines, and reserve antibiotics. According to the association, the effective savings volume currently stands at only 2.6 billion euros.
The GKV-Spitzenverband argues that implementing the location clause as currently designed would effectively halve the remaining savings potential of 2.6 billion euros by shifting the associated costs onto the GKV. The association’s spokesperson emphasized that the federal government and the Bundestag had agreed to avoid imposing additional financial pressures on contributors and wage costs when devising a location clause. He stressed the need to uphold this principle, adding that promoting local industry is not the responsibility of the statutory health insurance system.
