Germany: Dearer Drug Prescribing?

The pressure on German doctors from the Health Structure Law to be economic in prescribing is easing as they prescribe more and more costly drugs, says Heidelberg pharmacologist Ulrich Schwabe, in his 1994 report on prescribing. In addition to the prescribing of more expensive drugs, the evidence shows that generics are in retreat and are losing market share, he says. In first-half 1994, western German drug sales rose 7.3% or 800 million Deutschemarks ($518.3 million) over first-half 1993.

Dr Schwabe's claim is rejected by the association of research-based drugmakers for failing to discriminate among products. it says doctors are using modern drugs for which there are no generic copies.

Meantime, a report by the local health funds' scientific institute says patients will contribute about 3 billion marks ($1.9 billion) to their total drug costs in 1994, an increase of around 800 million marks over last year and a tripling of the 1992 contribution. On average, people are paying a tenth of the cost of their drugs in western Germany, and 8.7% in the eastern states.