Gesundheit: „Erklären Sie das mal den Amerikanern“: Koalition will Pharmafirmen entlasten – Krankenkassen warnen

The German government aims to provide relief to pharmaceutical companies by reducing their manufacturer discount, under certain conditions, when they meet specific criteria. A specialized panel comprising members from the Federal Health and Federal Economy Ministries has submitted concrete proposals. However, criticism has emerged from both pharmaceutical companies and health insurance organizations.

The panel's 60-page report outlines which companies will receive reduced manufacturer discounts, with the level of relief increasing based on the company's engagement in Germany. This condition is intended to be implemented within the year. The government hopes that these savings will prevent significant increases in health insurance contributions next year.

Part of these savings is expected to be contributed by the pharmaceutical industry. Starting from January 2027, the manufacturer discount for patented medicines is set to rise by 8.5 percentage points to 15.5 percent, up from the current 7 percent. The discount is currently seven percent. The location clause creates exceptions, with companies needing to meet criteria such as treating at least two percent of participants in clinical studies within Germany, a threshold that will gradually increase to four percent.

A tariff binding would provide an additional two percentage points of relief. Companies that allocate at least seven percent of their revenue to statutory health insurance for research and development in Germany will receive three additional percentage points. Additional relief of 3.5 percentage points is granted for production or investment if a company invests at least 500 million Euros in Germany within five years.

Companies that meet all criteria continue to pay a manufacturer discount of seven percent instead of the planned 15.5 percent. "Read also: World leader in the provinces: How Germany's largest pharmaceutical company manages its executives Industry insiders: 'Explain this entire set of criteria to the Americans' In the pharmaceutical sector, the standards have provoked criticism.

'I sit here and I have to update Global again,' said an insider to the Handelsblatt. Many companies will first need to calculate whether they meet the requirements, the insider added. 'Germany is already a concern due to complicated bureaucracy. These criteria do not improve the situation and are not in the interest of global companies,' said industry insiders.

Another insider noted: 'I don't see where we are being spared.' The CEO of US pharmaceutical company Eli Lilly, Dave Ricks, believes the exceptions do not go far enough. 'We're just talking about getting a little better than the starting point. That doesn't excite me much,' he said in an interview with the Handelsblatt at the sidelines of the annual meeting of the European Diabetes Research Society in Milan.

The location clause is not enough to reverse the anticipated investment withdrawal in Alzey planned for summer. Alexander Horn, Germany's CEO of Eli Lilly, sees the location clause as a first step towards relief in Germany, but not a comprehensive one. 'The framework conditions remain poor. What we need is a real structural reform of the health system,' he said.

Other pharmaceutical companies express a more positive view. Daniel Steiner, Germany's CEO of Swiss company Roche, calls the proposals an important shift in perspective, noting that for the first time, health and industrial policy are being considered together, including the economic significance of their industry for value creation, growth, and employment in Germany.

Health insurance organizations warn against the exemptions, arguing that they could eliminate up to 1.3 billion euros of the planned savings. The higher manufacturer discount is initially expected to save 4.1 billion euros, but existing exemptions could reduce this to 2.6 billion euros, the association estimates. The location clause could further halve the savings.

The report suggests that the recommendations for decreasing or eliminating manufacturer discounts ignore the goal of stable contribution rates. Stefanie Stoff-Ahnis, deputy CEO of the GKV Association, states that the measure fails to explicitly exclude funding the health insurance location promotion as a core part of industrial and economic policy.

The Greens also criticize the proposals, stating that the CDU, SPD, and CSU have completely given in to the pharmaceutical industry, imposing an additional billion euros in costs for ordinary and low-income earners, without a plan for financing these costs. The panel itself estimates that the savings will be reduced to between 750 and 850 million euros per year.

This analysis accounts for a maximum of approximately 300 million euros through the tariff binding, around 200 million for research and development, and 340 million for investments and production. The mandatory criterion for clinical trials is not yet taken into account. The GKV Association's higher estimate is based on unclear figures.