German Doctors Face Drug Budget Problems

The German panel doctors' federation, the KBV, says panel doctors have exceeded their budgets in prescribing dearer and more innovative drugs in 18 out of 23 panel regions. Joint chairman Peter Schwoerer estimates that the average panel doctor will have to forfeit 10,000 Deutschemarks ($7,307) in Bavaria, over 30,000 marks ($21,921) in Lower Saxony and Berlin and up to 50,000 marks ($35,185) in the eastern states of Mecklenburg-Verpommern and Saschsen-Anhalt. He says this scale of forfeit is no longer compatible with the economic survival of most panel doctors.

Doctors' drug budgets were exceeded last year in five panel areas by a total of 200 million marks, mainly in the eastern states and Berlin. However, say the latest figures available to the KBV, each panel doctor in eastern Germany will have to forfeit about 10,000 marks for exceeding his/her regional budgets. In some areas the forfeit could be as much as 30,000 marks.

Dr Schwoerer says the overall medical outpatient treatment budget was undershot in 1993 by some 6.3 billion marks and in 1994 by about 600 million marks. Since the budget arrangements were regionalized in 1994, the undershoot in some areas was not offset against overshoot in others. The KBV is now urging Health Minister Horst Seehofer not to use the drugs budget against doctors until some concrete spending data are available. It is backed by the drug industry association, the BPI, but the other grouping of research-based companies, the VFA, is seeking an end to the budget system altogether.