Effects Of Legislation On Drug Supply In germany

Before Germany's health insurance reform law of 1992, attempts to curb rising drug spending had met with little success, according to Gerhard Schulte, head of the directorate general for public health care and health insurance at the German federal Ministry of Health.

He told IMS International's European symposium (Marketletters November 14 and 21) that neither the rise in copayments from 1 Deutschemark per prescription to 3 marks per drug, nor the introduction of reference prices by the health reform law of 1988 brought change, although reference prices "have been and continue to be highly successful." 60% of German drug turnover now has a reference price, saving 1.5 billion marks ($963 million) a year.

The 1992 health reform law was the first to achieve any clear savings for the health funds' drugs bill, he said. Turnover in 1993 fell 3.9 billion marks in the old western German states, largely due to the bill's introduction of the drugs budget. The trend for 1993 was for improved drug therapy in spite of cost reduction, he said. Prescribing of products of disputed efficacy was considerably reduced, saving 1.8 billion marks, and that of high-quality, innovative products rose. The share of the market accounted for by generics rose to 38%, compared with 34.5% in 1992, leading to savings of 350 million marks. Additionally, the price cuts stipulated by the reform law led to further savings of 1.1 billion marks in the year.