German patients may see easing charges

The Social Democrats (SPD) and Christian Democrats (CDU) in the German coalition government have agreed to changes in the projected plan to make further economies in the drug sector. Health funds are to be allowed to remove patient charges in certain cases where drugs are prescribed which are regarded as representing value for money with a high cost-benefit rating. The health funds would decide on a joint basis which drugs to include on the list of patient-charge exemptions.

The government hopes that this new regulation will achieve savings in drug spending because patients will only benefit directly if doctors prescribe economically. The rules relating to drug prescriptions are also to be modified. The original draft of the regulations presented by Health Minister Ulla Schmidt envisages cuts in doctors' fees if they prescribe an above-average number of drugs or prescribe costly drugs.

Doctors are also to get bonuses if they prescribe economically. This rule is now to be altered in the final draft of the new regulations with the prescribing limit set at 10%, overstepping of average drug numbers instead of 5%. Coalition health policy advisers are understood to have agreed that in any event this "good prescriber-bad prescriber" rule would only be brought into play if health funds and the medical profession cannot agree on what constitutes economic prescribing and in cases where the drugs savings target cannot be achieved.