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German private health insurers say much more likely to pay for new drugs than statutory providers

Country : Germany

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by Katharina Wecker
BERLIN, Mar 11 (APM) - Germany’s private health insurers have said they spend 43% more per insured patient on new drugs than their statutory counterparts, and highlighted this as an example of the limitations of the country's health technology assessment (HTA) in getting the best treatments to patients.
Members of Germany’s association of private health insurers, the PKV, accounted for 15.7% of the country's spend on new drugs, despite only accounting for 11% of the insured populations, according to figures collated by the PKV's scientific institute, the WIP.
This means that the statutory health insurers payer group GKV Spitzenverband’s share of the new drug market was 84.3% while 89% of Germans are statutorily insured, WIP claimed.
“The most striking result of the study was that privately insured people have better access to new drugs and especially drugs rated by the G-BA as having considerable added benefit", Frank Wild, author of the WIP study told APM on Tuesday.
“This is mainly due to the fact that, unlike the PKV, the GKV Spitzenverband needs to follow numerous regulations to save expenses. A private doctor can decide freely and without any economic consideration which drug is best for the patient,” Wild argued.

Drug spend in Germany increasing

According to the study, private health insurers spent 16.2% of their 2011-2013 budget on drugs ruled as having considerable added benefit and 14.2% on drugs with low added benefit.
Comparable figures of the GKV Spitzenverband are not available as the statutory health insurers don’t compile their data this way, a GKV spokeswoman told APM on Tuesday.
In total, the PKV spent 2.59 billion euros on drugs in 2013, an increase of 130 million euros or 5.3% over the previous year.
The GKV Spitzenverband spent 30.9 billion euros on drugs in 2013, 2.4% more the previous year.
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