Already in the recent past, disputes between the German Pharmacists‘ Association (DAV) and the GKV-Spitzenverband regarding the auxiliary tax system for parenteral preparations by cyto-pharmacies have frequently occurred. On 1 March 2020, an arbitration award agreed on new prices for parenteral preparations from ready-to-use drugs in cancer therapy, but this has led to criticism of the „complicated and error-prone“ system by the Working Group on Parenteral Preparations, or ARGE PareZu for short, which criticises Annex 3 to the contract on the pricing of substances and preparations. In the eyes of the Working Group of Cyto Pharmacists, there are many inconsistencies. In addition, in the opinion of ARGE PareZu, the new regulations between the two contracting parties represent an incalculable risk in many respects, especially for smaller manufacturing companies, as in some cases retroactive discounts have to be paid on active substances or finished drugs which have been newly introduced to the market or have become generic drugs. This also applies from 1 March 2020. From the point of view of cyto-pharmacists, who have had to pay a retroactive discount of 25 percent for an active substance „treosulfan“ since 1 November 2018, this is an „unreasonable and existential risk for manufacturing pharmacies“, which, however, according to the auxiliary tax, may not go back more than 16 months. Nevertheless, this regulation may mean the end for some smaller companies that ensure the supply of parenteral preparations close to their homes by means of short transport routes while adhering to the shelf-life specifications, especially since another critical point in the regulation has not been touched. The working group also criticises the unaltered working prices, which remain stable but are far too low in the opinion of the manufacturing pharmacies. The current working price cannot meet the quality of the preparations to be produced. This could also have a negative impact on the situation of smaller manufacturing companies. Retroactive discounts and too low working prices, but also far too complicated regulations make the daily work of many cyto pharmacies more difficult. Therefore, the working group urgently demands a renegotiation of the auxiliary tax, taking into account a professionalized negotiation with the umbrella organization of the statutory health insurance companies, so that a consensual agreement between pharmacies and health insurance companies can finally be reached.
