Abstracts by keywords: rebate 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 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
Direct contracts started out as discount contracts for pharmaceuticals. In the meantime, however, it is becoming apparent that they are covering more and more areas of care through general practitioner and specialist contracts. Everyone should benefit from these contracts: Health insurance companies have a better influence on the service, service providers receive better remuneration and patients better care. But it shouldn't cost more either. Whether this is successful can only be shown by means of health services research. It should also be noted that direct contracts must not put you in a worse position than standard care. This specification, which has received little attention in the previous discussion, is a steep template for health services research.
01.06.2009
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.