gms | German Medical Science

Aim of the study: The adoption of new legislation in the health service entails considerable changes in the consumption of medicinal products after only few months. Since April 1^st, 2007, discount agreements based on the GKV-WSG (German Statutory Health Insurance Competition Enhancement Act) apply which were originally issued for 42 active ingredients. The analyses referenced here focus on the impact of these discount agreements on physicians, pharmacists, and patients.

Method: The data are based on prescriptions submitted with >99% coverage, presented on a monthly basis by regions and all individual health insurance companies. Quantitative data were completed by a survey conducted with physicians and patients selected at random.

Results: The discount agreements with defined manufacturers of generic products have a strong impact on the research conducted on the supply. The discount agreement of the AOK, one of Germany’s major statutory health insurance companies, alone has a considerable influence on the market share compared with the total market. The changes brought about can be clearly illustrated with the example of simvastatin: The 3 top manufacturers of generic products lost a market share of 18%, while the manufacturer with the discount agreement grew by 13%.

In an on-line survey conducted in 5/07, many physicians indicated that discount agreements had not yet led to a change in their prescribing behaviour. Most patients (51.5%) indicated that they expect “their” product to be prescribed for the future, too.

Conclusion: The new laws have had considerable consequences for physicians, patients, health insurance companies, and pharmaceutical manufacturers. Undesirable effects include an increase in non-compliance and a lower persistence in courses of treatment.