Regulation of pharmaceutical markets in Germany: improving efficiency and controlling expenditures?
Article first published online: 15 NOV 2005
Copyright © 2005 John Wiley & Sons, Ltd.
The International Journal of Health Planning and Management
Volume 20, Issue 4, pages 329–349, October 2005
How to Cite
Busse, R., Schreyögg, J. and Henke, K.-D. (2005), Regulation of pharmaceutical markets in Germany: improving efficiency and controlling expenditures?. Int. J. Health Plann. Mgmt., 20: 329–349. doi: 10.1002/hpm.818
- Issue published online: 15 NOV 2005
- Article first published online: 15 NOV 2005
Rising pharmaceutical expenditure has become a major concern for policy makers in Germany over recent years. Therefore, the pharmaceutical market has been increasingly targeted by different kinds of regulation, focussing on both the supply and the demand side, using price, volume and spending controls. Specific regulations include price reductions, reference pricing, pharmacy rebates for sickness funds, increasing co-payments, an ‘aut-idem’ substitution, parallel imports, a negative list, directives, 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. In spite of being opposed by 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 detrimental. Copyright © 2005 John Wiley & Sons, Ltd.