The scientific institute of the AOK, WIdO for short, is a research and consulting institute of all AOKs and provides expertise for all service areas in the SHI system. In a current report, the institute describes the advantages of drug discount contracts, which can save a lot of money in the GKV. Health insurance companies are proponents of exclusive tenders, pharmacists, on the other hand, are opponents because if the drug is not available, a bottleneck arises because no alternative preparations are available. However, the WIdO argues differently, because a savings volume of approximately two billion euros in 2019 allegedly proves the AOKs right. The types of contracts and thus the variety of product providers can vary. For example, the open-house model is popular, but the AOK’s favourite is the exclusive contract, under which only one manufacturer receives the exclusive right to supply its drug. Discount negotiations are, however, covered in silence, but the highest savings can probably be achieved with exclusive tenders. Since the manufacturers in these contracts can calculate large sales quantities, the discounts are also considerably higher. Larger and better-known manufacturers are also at an advantage here, because they can offer a wider range of products through so-called multi-partner contracts and are thus more broadly based and can assert themselves. According to the WIdO, pharmacies also benefit from this because they can focus their stockholding on these suppliers. The Institute’s analysis also provides evidence that patients are at an advantage if they are always supplied with one and the same drug and do not have to constantly change suppliers. The Institute is certain that manufacturer loyalty leads directly to more successful therapy. If only one discount partner existed, 83 percent of all patients always received the same drug in 2018, according to the report. However, if a discount contract expires, patients would have to change the supplier. The Institute is not critical of supply shortfalls due to supply bottlenecks, because sole contractual partners would calculate better and in larger sales volumes if pharmacies also follow suit and calculate larger prescription quantities and order in stock. The WIdO also sees a lower risk of production losses in globalised production and criticises the EU plans to bring the production of drugs back to Europe. Discount agreements are also not responsible for the relocation of production to other countries. In addition, only 3.6 per cent of drug expenditure worldwide is accounted for by the SHI system in Germany, the argument goes on to say.
Source: pharmazeutische-zeitung.de