ABSTRACT
Germany has a predominantly mandatory healthcare system that is run by competing sickness funds. Paul Ehrlich Institute holds responsibility for the licensing of blood, blood products, sera and vaccines in Germany. Prior to the introduction of Arzneimittelmarkt-Neuordnungsgesetz, rebates were already an increasingly popular phenomenon in Germany. Particularly for generic drugs, it has become customary for companies to reach agreements with sickness funds to obtain favorable treatment in exchange for confidential rebates. Germany and the Netherlands share the perhaps dubious honor of being the innovators in the introduction of what is internationally known as reference pricing. In Germany the term “price referencing” is used, since formally it is not used to set price, but rather to establish reimbursement limits. Pharmaceuticals that are available on the shelf in Germany, but sourced from lower price markets in Europe, are subject to the same reimbursement conditions as their locally distributed equivalent.
