The financial burden of covering weight-loss injections could potentially cost the statutory health insurance system (GKV) billions of euros in the most extreme scenarios. Carola Reimann, head of the AOK federal association, told media outlets that if all GKV-insured patients with a Body Mass Index (BMI) of 30 or higher were routinely treated, estimated annual costs would reach around 45 billion euros. While she stressed this is a theoretical maximum, the figures reveal the immense financial scope of the debate.
The possibility of covering the costs of these weight-loss injections for severe obesity had recently been introduced by Sonja Optendrenk, the new chair of the Joint Federal Committee (G-BA). Reimann warned that this issue cannot be viewed in isolation, noting that the GKV already pays for these medications for patients with diabetes. Additionally, she highlighted a “massive media hype,” pointing out that some people misused the substances “for cosmetic reasons without medical background.” Following Reimann’s calculations, if the BMI were 35 or higher, the annual costs would still amount to approximately 14 billion euros, again reiterating that this is a maximum scenario.
Beyond the discussion of obesity treatment, Reimann expressed general concerns regarding the trajectory of drug expenditures. She stated that the prices for many new medications are excessively high upon market entry because manufacturers are allowed to set prices freely during the initial six months. Although the GKV is prepared to pay for therapies that offer significant added benefit, the critical problem is that an increasing number of treatments lacking demonstrable added benefit are also being introduced at high prices. Reimann concluded by noting that for medications targeting rare diseases specifically, the expected benefit is sometimes assumed upfront but is not adequately validated later on.
