Abstracts by key term: Discount contracts
Data on the use of drug migraine therapies in children in routine practice are limited. The aim of this study is to analyze and evaluate the prescribing patterns of acute migraine therapies in outpatient pediatric practices in Germany. This retrospective, cross-sectional study includes children aged 2–12 years with a migraine diagnosis diagnosed by one of the 250 participating pediatricians between January 2015 and December 2023. 10.9% of the children aged 2–5 years and 18.3% of the children aged 6–12 years received a prescription for migraine medication. The most frequently prescribed active ingredient was ibuprofen (75.4% and 75.9%, respectively), which is available in various dosage forms. Among children aged 2–5 years who received an ibuprofen prescription, 68.2% received ibuprofen as a suspension, 16.3% as rectal suppositories, and 15.5% as orodispersible tablets. In the 6–12 year age group, suspension (36.3%) was the most frequently prescribed dosage form, followed by orodispersible tablets (31.8%) and solid tablets (29.9%). The proportion of orodispersible tablets was significantly higher among privately insured patients than among publicly insured patients (53.7% vs. 31.0%) and higher in 2015 compared to 2024 (40.5% vs. 24.8%). Orodispersible tablets appear to be the preferred dosage form for children, but they cannot always be prescribed due to discount agreements.
02.06.2025
The aim of the drug discount agreements in accordance with Section 130a Paragraph 8 of the Social Code V (SGB V) is to promote the exchange of drugs with the same active ingredients in accordance with Section 129 SGB V and thus reduce the drug costs of statutory health insurance companies. Due to the sharpening of discount agreements by the GKV-WSG on April 1, 2007, the topic of drug substitution has increasingly become the focus of interest and health policy discussions. However, replacing a medication with a discounted product is not always without risks. There are certain diseases or “critical indications” for which substitution is problematic due to the discount agreements agreed between drug manufacturers and statutory health insurance companies. This particularly affects patients with long-term drug therapy, such as: E.g. epilepsy patients or so-called “critical dose drugs” (active ingredients with a narrow therapeutic range). Exchanging drugs can have negative effects on the further course of the disease (seizure recurrences, toxicity), at least in well-controlled patients with epilepsy. The German Society for Neurology (DGN) therefore warns in its guidelines against an uncontrolled exchange of antiepileptic drugs in stable and well-controlled patients (DGN 2008).
04.10.2012
The development in health care includes the implementation of contracts between different players as one of the main regulating factors. Contracts don't run by themselves; it's not enough to agree on content and sign it. The evaluation must be taken into account and planned as early as when the contract is concluded, and not only after 3 years, but continuously and concomitantly. The appropriate source for the information, as well as the type and amount of information required, depends on the type of contract and the content of the contract. In order to consider selective contracts with doctors or groups, data and evaluations from random samples of relevant size, which also allow regionally valid considerations and extrapolations, are required. Evaluations from billing data are not sufficient here because they do not adequately reflect medical behavior.
23.09.2012
Discount contracts have played a prominent role in the pharmaceutical supply of statutory health insurance (GKV). This competitive field has undergone dramatic change in many respects. Not only contract design, implementation, but also legal assessment and public perception have changed. Implementation problems from the beginning have largely been resolved. The savings from the contracts are essential for the GKV - every statutory health insurance company has reported numerous contracts. The article provides an overview of the experiences of the German BKK.
01.06.2010
The instrument of drug discount contracts was implemented in the statutory health insurance (GKV) system in order to curb drug spending in the outpatient sector. The GKV Competition Strengthening Act (GKV-WSG), which came into force on April 1, 2007, paved the way for health insurance companies to be able to conclude discount agreements with pharmaceutical manufacturers more effectively than before. Since then, pharmacists have had to give preference to discounted medications. Ideally, both manufacturers and health insurance companies can benefit from such discount agreements.
01.06.2010
The past and presumably also the current reforms of politics in the pharmaceutical sector strengthen the service providers working in the field of discount agreements according to §130a SGB V for the GKV. The reason for this lies essentially in the complexity of the materials as well as in the bundling of demand volumes. Despite the merger of several health insurance companies, however, they wish to see their individual interests reflected in the contract. Service providers like GWQ ServicePlus AG are measured by whether they enable individual contract strategies in the pharmaceuticals sector on the one hand and whether they successfully achieve high discounts on the other. This is accompanied by the complex task of the technical implementation of the contracts and also a far-reaching consulting service on drug contracts. This concerns pharmaceutical, procurement law, data technology and financial aspects.
01.06.2010
The “Aut-idem” regulation and the discount agreements according to Section 130a Paragraph 8 SGB V are among the most important regulatory measures regarding pharmaceutical expenditure by statutory health insurance. Both measures aim to replace patent-free original preparations with cheaper preparations with the same active ingredients, so-called generics. However, preparations with the same active ingredients are not necessarily identical to the original due to the use of other excipients and carriers as well as the permitted tolerances for the active ingredients. Exchanging the preparation can have a negative impact on the course of diseases with a narrow therapeutic range, such as epilepsy, due to these tolerances. In this case, recurrent epileptic seizures can mean that the replacement does not save any costs, but rather generates additional expenses. Epilepsy is therefore an indication in which value-added contracts should be concluded instead of discount tenders. These focus not only on cost savings, but also on optimizing patient care.
17.12.2008
It is currently becoming apparent that the discount agreements are reinforcing a development that leads to market results that do not do justice to the relative or absolute value of the medicines and thus lead to allocative inefficiencies. Against this background, a proposal for a central approach to controlling the generic drug market, based on a cost-benefit assessment, was developed. The core of the model is that the reimbursement prices in the statutory health insurance are set in such a way that they reflect the benefit ratio of the drugs to each other. In this way, the approach induces a needs-oriented and efficient distribution of scarce resources in drug supply. The approach also offers a pragmatic multi-step scenario with budget neutrality in the introduction phase of the model.