Tender the supply of cytostatics to doctors' practices regionally again
24.07.2023 14:40
In view of the current reporting “The Cancer Cartel” by the ARD political magazine “Monitor”, NDR, WDR and Süddeutsche Zeitung about profitable business models and high profit margins in cytostatic pharmacies, the AOK Federal Association is calling for the legal reintroduction of regional tendering options.
“For years, the AOK community has been problematizing the existing purchasing advantages for pharmacies for cancer drugs. The lists that have recently become known now show that these advantages actually still exist. The pharmacy can apparently sometimes charge several hundred euros extra for each prescription prepared - in addition to the actual remuneration for the labor, which is already sufficient. “The overpriced amounts come entirely at the expense of those paying contributions,” explains Dr. Sabine Richard, Managing Director of Supply at the AOK Federal Association.
The research association's reporting also shows that the health insurance companies' negotiation instruments currently provided for by law are not suitable for achieving fair remuneration. With the help of the so-called auxiliary tax, necessary price adjustments could only be implemented with a considerable time delay and - within the framework of the planned negotiated solution via an arbitration decision - only partially.
In the course of the research, Federal Health Minister Lauterbach announced regulatory measures. Richard: “The AOK community's specific demand in this context is: Give the health insurance companies back the opportunity to tender regionally for the supply of cytostatics to doctors' practices in a transparent process. We have repeatedly advocated for the possibility of health insurance companies being able to conclude regional economic contracts with individual pharmacies that supply doctors. Years ago it was about savings of at least 600 million euros per year for the entire statutory health insurance. However, after a campaign by pharmacists and doctors, these contracts were banned by law in 2017.”
The obvious connections between doctors and supplying pharmacies or manufacturing companies also worry supply expert Richard. “For good reasons, it is one of the basic principles of health care that doctors should not earn money from what they themselves prescribe. Conversely, drug suppliers are not permitted to buy up doctor’s offices for distribution purposes.”
Pharmacies are therefore no longer allowed to set up medical care centers. In order to prevent possible misconduct, doctors should not choose which pharmacy supplies the parenteral preparations themselves.
Here, too, regional tenders by pharmacies could put a stop to this. Since the ban on regional health insurance contracts, doctors are once again allowed to decide for themselves from which pharmacy they want to obtain cytostatics. This makes buying up the practices so attractive for suppliers of cancer drugs.
Richard: “Patients must be able to rely on doctors recommending the best therapy for them and not pursuing any other interests. We therefore also need comprehensive transparency about the actual ownership structures of the medical care centers.” It must be prevented that oncological care is further concentrated and that unreasonable profits are generated at the expense of those paying contributions.