Law to combat drug supply shortages does not deliver what it promises
01.08.2023 12:49
Large parts of the Medicines Supply Bottleneck Combating and Supply Improvement Act (ALBVVG) have come into force since July 27th. This comments Dr. Carola Reimann, Chairwoman of the AOK Federal Association:
“The expectation that the name of the law arouses, namely to combat supply bottlenecks in the long term, is not being fulfilled. The legislature has used unsuitable instruments that do not get to the root of the problem, but generate large additional economic expenses for statutory health insurance (GKV). Exempting entire drug groups from discount agreements and fixed amounts or raising price caps by up to 50 percent are not suitable for making the supply of drugs safer. This is shown by the example of fever juices for children. Although the fixed amounts have been suspended until the end of the year, that does not mean that fever juices will be available in every pharmacy in the country.
Weakening of discount agreements
Another big problem is the weakening of discount agreements. The massive current and potentially possible restrictions on this important instrument prevent the GKV from leveraging important economic reserves. This is a wrong decision by the legislature. It is fundamentally clear that discount contracts demonstrably stabilize existing supply chains due to the better ability to plan requirements and stockpiling requirements and thus strengthen security of supply. Billing data from the GKV for 2021 shows that delivery defects occur less frequently with discounted medicines than with non-discounted medicines. The documented delivery failures in the supply with discount contracts were only 1.2 percent, while in the patent-free market without discount contracts the failures were more than three times as high at four percent.
Supply bottlenecks are a global problem
Be it fever syrups, cancer drugs, antibiotics or psychotropic drugs: supply bottlenecks are an ongoing and global problem that cannot be solved solely through price. Germany's share of the global pharmaceutical market is only four percent. The ALBVVG's requirements for the early warning system and minimum stocks for drug manufacturers are definitely a step in the right direction.
Comprehensive early warning system urgently required
However, direct security of supply should be addressed promptly: a comprehensive early warning system for all medicines that can be billed to the statutory health insurance provider along the entire value chain is essential. As a result, suppliers, pharmaceutical companies, wholesalers and also pharmacies must be included. It is therefore incomprehensible why medicines that are not discounted are excluded from this. Furthermore, it is incomprehensible that there continues to be a massive imbalance of interests in the advisory board of the Federal Institute for Drugs and Medical Devices (BfArM) in favor of the pharmaceutical industry.
Overall, it can already be said that the law does not deliver what it promises. Significant additional expenditure is to be expected without effectively increasing security of supply. This means that there is a risk of further premium increases for our insured persons.”