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Managing pharmaceutical regulation in Germany: Overview and economic assessment

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  • Schreyögg, Jonas
  • Henke, Klaus-Dirk
  • Busse, Reinhard

Abstract

Rising costs in pharmaceutical expenditure have become a major concern for policy makers in Germany over the last years. Therefore the pharmaceutical market in Germany has been increasingly targeted by different kinds of regulations, focussing both on the supply and the demand side, using price, volume and spending controls. Specific regulations include price reductions, reference pricing, pharmacy rebate for sickness funds, increasing co-payments, an "aut-idem" substitution, parallel imports, negative list, guidelines, and finally spending caps for pharmaceutical expenditure per physicians' association. Although it is difficult to attribute certain effects to single measures, some measures like reference pricing and physician spending caps are more effective and long-lasting than others. Although highly disputed among physicians, the spending caps applied between 1993 and 2001 have limited pharmaceutical expenditure for an entire decade. However, while some measures do effectively control expenditures, their effect on allocative efficiency may be negative.

Suggested Citation

  • Schreyögg, Jonas & Henke, Klaus-Dirk & Busse, Reinhard, 2004. "Managing pharmaceutical regulation in Germany: Overview and economic assessment," Discussion Papers 2004/6, Technische Universität Berlin, School of Economics and Management.
    • Handle: RePEc:zbw:tubsem:20046
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    References listed on IDEAS

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    1. Giuliani, Giovanni & Selke, Gisbert & Garattini, Livio, 1998. "The German experience in reference pricing," Health Policy, Elsevier, vol. 44(1), pages 73-85, April.
    2. von der Schulenburg, J. -Matthias Graf, 1997. "Management of cost and utilization of pharmaceuticals in Germany," Health Policy, Elsevier, vol. 41(Supplemen), pages 45-53, September.
    3. Schneeweiss, Sebastian & Schoffski, Oliver & Selke, Gisbert W, 1998. "What is Germany's experience on reference based drug pricing and the etiology of adverse health outcomes or substitution?," Health Policy, Elsevier, vol. 44(3), pages 253-260, June.
    4. Perleth, Matthias & Busse, Reinhard & Schwartz, Friedrich Wilhelm, 1999. "Regulation of health-related technologies in Germany," Health Policy, Elsevier, vol. 46(2), pages 105-126, January.
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    Cited by:

    1. Allen, Pauline & Hommel, Petra Riemer, 2006. "What are `third way' governments learning? Health care consumers and quality in England and Germany," Health Policy, Elsevier, vol. 76(2), pages 202-212, April.

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