Higher co-payments for medicines

Higher co-payments for medicines

As of today, new co-payments of 5 to 10 euros are due for a number of medications

In future, legally insured patients will expect to be paid an additional five to ten euros per prescribed medication, because on July 1st the health insurance companies lowered their maximum reimbursement amounts for thousands of medications and the pharmaceutical manufacturers did not reduce their prices to the same extent, according to the German Pharmacists' Association (DAV ).

According to the information provided by the German Pharmacists' Association, millions of legally insured patients can expect corresponding additional payments when buying medicines. Because "medicinal products are only exempt from payment if their price is at least 30 percent below the respective fixed amount", the DAV said. If the latter is lowered, many medicines are exempt. Current calculations by the DAV have shown that "the number of medication exempt from co-payments will decrease by more than a third from 4,800 to 3,000 compared to the previous month". In the case of the approximately 33,000 drugs that are subject to a fixed amount, the co-payment exemption rate drops from almost 15 to less than 10 percent.

Pharmacies are obliged to demand additional payments In view of the looming discussions about the necessary additional payments when buying medication that has previously been exempt from payment, the German Pharmacists Association has expressly pointed out in its current press release that “all pharmacies are legally obliged to collect additional payments for the statutory health insurers from the insured and to the health insurance companies. ”In 2013, the patient co-payments reached a new high in favor of the statutory health insurance (GKV), the DAV further reports. In mathematical terms, pharmacies would have to pay additional payments of € 2.60 per pack. On the basis of the computer program used, it is automatically recognized "whether a preparation is subject to payment or exemption."

Additional payments of at least 5 euros and a maximum of 10 euros According to the German Pharmacists' Association, the additional payments for prescription medicines amount to ten percent of the price. "At least it must be 5 euros, at most it can be 10 euros," reports the DAV. The additional payment is limited to the actual cost of the drug. "On the other hand, additional payments or additional costs should not be confused with the statutory co-payments: They must also be paid by the patient if the drug price is above the fixed amount", the association announced. Here, however, individual statutory health insurers could “waive additional costs for their insured persons for medicinal products through which they have concluded discount contracts with manufacturers.”

In its current press release, the German Pharmacists Association continues to make it clear that the fixed amount reductions also have painful side effects for pharmacies. Because there is a loss of inventory value, "if medicines were procured by the manufacturer at a higher price than the cut-off date than they can then be billed to the health insurance company." (Fp)

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