fever and cough syrups
Minister of Health Lauterbach announces measures against bottlenecks in medicines for children
Federal Health Minister Karl Lauterbach (SPD) presents measures against the shortage of children’s medicines: “Repatriation of production to Europe, then price adjustments where delivery bottlenecks are evident. Storage for several months and a radar system at the Federal Institute for Drugs and Medical Devices (BfArM), where Impending supply bottlenecks can be identified before they really take effect. This enables us to present the availability of generics in the long term and the short-term effect on the children will have an immediate impact. Because we are currently still able to deliver in other European countries. If we raise the prices there, we will a larger part of the amount also come to Germany. The preparation of alternatives by the pharmacists is excluded from the economic test, so that there is clarity here for the various doctors, but also for the pharmacists. Everything will be reimbursed. And as I said, we are increasing the reimbursement of the ability d he medicines for the juices, which are scarce here, immediately by 50 percent, so that there are also offers on the market that would not be on the market at the current fixed price.” “Germany has these problems because we were actually very radical when it came to pricing generics. Here we really used a system where prices were pushed down so much that only the cheapest manufacturer had a chance on the market. We have now gone so far. I have already complained about a similar problem with the way in which we proceed with case flat rates in certain areas of the hospital. Economic efficiency is an important requirement. But you mustn’t over-tighten the screw.” “In fact, we have to expect additional costs here, but we need a certain security and the current system doesn’t work. These are not big costs. We will quantify them exactly. We have to act quickly here. Yes, but the majority of drug costs are incurred for drugs with patent protection and not for drugs without patent protection. So additional costs are to be expected here. However, they are not relevant to the contribution rate. But we have to spend money here, otherwise the system cannot work .”
In pharmacies in Germany, medicines for children, such as fever and cough syrups, have become a scarce commodity. The Federal Minister of Health now wants to take countermeasures quickly – and also explains how.
According to plans by Federal Minister of Health Karl Lauterbach, the range of important medicines, especially for children, should be better protected against supply bottlenecks. “We have overdone it with the economization in the supply of off-patent medicines,” said the SPD politician on Tuesday. To counteract this, the cornerstones of a law include new price rules. This should make deliveries more economically attractive for providers. European producers should generally have a stronger say. The statutory health insurance companies spoke of a “Christmas present” for the pharmaceutical manufacturers, who in turn welcomed the plans.
Lauterbach explained: “It is unacceptable that it is difficult to get fever syrup for your child in Germany that is still available abroad.” Therefore, the pricing of children’s medicines should be radically changed. “If, for example, young patients have to switch to more expensive medicines, the health insurance companies will in future have to bear significantly more costs than they do today. In the short term, this will ensure more pediatric medicines are available.” Recently, there have also been bottlenecks in preparations for adults, such as antibiotics and cancer drugs.
An overview of the planned price levers:
children’s medication
For certain medicines, up to 1.5 times the “fixed amount” is to be paid by the statutory health insurers – i.e. the maximum amount that they have previously paid to the manufacturer for a preparation. Lauterbach said on ARD that the cash registers would be instructed immediately to pay this 50 percent more. According to the key points of the ministry, experts at the Federal Institute for Drugs and Medical Devices should create a list of preparations that are required for child care. In order to reduce cost pressure, there should no longer be any discount agreements for them.
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supply chains
The supply should generally be better secured, also against problems with deliveries from Asia and dependencies on individual suppliers. The health insurers are initially to be given “location consideration” for cancer drugs and antibiotics in tenders. In an additional part, in addition to the award based on the price, they should award a contract based on the criterion “share of active ingredient production in the EU”. This should ensure that more reliable European manufacturers are preferred, explained Lauterbach. Provision should also be made for certain funds to be kept in stock for several months.
pharmacies
The focus is also on pharmacies, which take care of alternatives for customers when products are currently not available. “If a drug is not in stock, they may in future sell a drug with the same active ingredient or make juices from pills,” explained Lauterbach. “If you have to consult the doctor for this, you will be rewarded for that.” According to the key points, a flat rate of 50 cents is provided. The Federal Union of German Associations of Pharmacists called the amount “an impertinence”. This does not even begin to subsidize hours of work.
observation
The supply situation should be monitored more closely in order to recognize earlier which funds are likely to be bottlenecked. The responsible federal institute should receive additional information from manufacturers and pharmaceutical wholesalers – for example on current production quantities by production site and on the storage of active ingredients, intermediates and finished medicinal products. According to the Federal Institute, there are currently a good 330 reports of delivery bottlenecks. The Ministry points out that there is not a supply bottleneck in each of these cases. So there would be alternatives.
The legislative plans are to be implemented in the new year. Lauterbach said a “discounter policy” had continuously worsened the supply for decades. “Turning it back won’t happen overnight.” Although patent-protected medicines tend to be expensive in Germany, the market for unpatented medicines has so far not been an attractive market. As a result, popular products tend to go to other countries such as the Netherlands, he explained on ARD. Funding should be discussed with the government. “I firmly believe that everyone here understands that we must act.” He is pulling in the same direction as Finance Minister Christian Lindner (FDP).
Health insurance companies are critical
Criticism came from the statutory funds. Head of the umbrella organization Doris Pfeiffer spoke of an “impressive Christmas present for the pharmaceutical companies”. It remains to be seen whether medicines will therefore be delivered more reliably to Europe or whether more will be produced here. From the point of view of the pharmaceutical industry, on the other hand, the ministry has finally recognized that the “principle of cheapness is the main thing” is destabilizing the supply. That goes to the root of the problem, explained the association Pro Generika. The German Foundation for Patient Protection does not expect any short-term miracles from the plans. “Savings craze” have long since reached those in need of care and those who are seriously ill, said board member Eugen Brysch. There was a lack of antibiotics and radioactive drugs. “That must have an end.”