Prescription Charges in Germany

Prescription Charges in Germany

Background

Germany has a highly decentralised statutory health care system covering 90% of its population. The remainder is either uninsured, or has some other form of insurance. The German statutory system is financed through payroll contributions and general taxes (80%) and the remainder is made up from patient payments and private insurance [2].

66. In 2004, a series of reforms of the health care and pharmaceutical market came into effect in Germany [1]. As part of this system, the state covers approximately 80% of the total cost of prescription medication [2]. German patients also have to pay a fee for doctor consultations.

Patient co-payments

Since 2004, patients in Germany have had to pay 10% of the reference cost of the medication plus any difference between this and the retail cost. In addition, there is a minimum contribution per pack (see below).

German co-payments per year as of 2005[1] (Contribution in General) is €5-10 per pack or 10% of the reference cost of the prescription medication.

Reduced Co-Payments

Under the German system since 2004 patients taking part in disease management programs or preventative medical checkups benefit from reduced co-payments or lower health insurance contributions [1].

Co-Payment Exemptions

Since January 2004 only children under 18 are totally exempt from co-payments [1].

Cap on Co-Payment

Also since January 2004 chronically ill patients in certain settings e.g. certain types of nursing homes, or with certain disabilities e.g. the severely disabled, who pay at least 1% of their gross family income on medical treatment and services, and anyone who contributed 2% of their gross family income on co-payments have a cap on any further payments above these levels. These percentages can be further reduced depending on whether a person has a spouse and the number of children in the family [1].

Resources

Notes

  1. Bronner, M et al (2005) Pharmaceutical Pricing & Reimbursement 2005: a concise guide, PPR Communications Ltd.
  2. Seget, S (2005) Pharmaceutical Pricing Strategies: price optimisation, reimbursement and regulation in Europe, US and Japan, Business Insights Ltd.

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