New government coalition plans AMNOG, pricing and other reforms

The new government in Germany is formed as a coalition of the three parties, SDP, FDP and the Green Party. At the end of November, they presented their plans for 2021 until 2025. These include a few reforms affecting market access and financing health care in Germany. The most crucial points are:

Benefit assessments

  • The new government states that they want to further develop AMNOG, although no details are given.
  • Through a reform of the G-BA, the parties aim to accelerate the decision-making, strengthen the patient representation and give nursing, care and other health professions additional opportunities to provide input when they are affected.

Pricing

  • The option for the SHI funds to limit drug prices will be further strengthened.
  • The negotiated reimbursement prices will apply retroactively from month 7 onwards.
  • The price moratorium will be extended beyond 2022. This means that manufacturers can’t increase the prices for products where prices were not negotiated through AMNOG.

In- and outpatient care

  • Services provided in the outpatient and inpatient sector should be reimbursed with the same rates through a Hybrid-DRG.
  • The new government wants to reform the structures of hospital and emergency services, and introduce sector-independent care.
  • They plan to amend the “Act to Strengthen Local Pharmacies” in order to better reward pharmaceutical services and to use efficiency gains within the financing system.
  • They want to introduce a Health Assurance Act (German: “Gesundsheitssicherstellungsgesetz”) in case of health crises. This law aims to ensure an efficient and decentralized storing of pharmaceutical products and medical devices as well as regular emergency training for the staff.

Digital health care

  • The focus of the digital advancements should be on solving existing health and care problems and the perspective of the users.
  • The parties want to promote telemedical services including medicinal and therapeutic prescriptions, as well as video consultation hours, teleconsultations, telemonitoring and tele-emergency medical care.

Care / nursing sector

  • The new government also plans to support the care sector. To this end, they plan to raise wages for care nurses, introduce tax relief and improve work hours etc.
  • Further, they want to supplement long-term social care insurance with a voluntary, full insurance, which completely covers all care costs.
  • The German Care council (German: “Deutscher Pflegerat”) will be represented at the G-BA.
  • The digitization of care should be focused on easier documentation, to promote participation and therapeutic applications.

The details of these plans are yet to be defined, and the changes will still have to be voted in by the members of the respective parties. This is expected to happen in the next few days.

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