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Country profiles of health system responses to the crisis | Germany
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Changes to health coverage
Population (entitlement)
• No response reported.
The benefits package
• New legislation (in effect since 2011) subjects all new pharmaceutical products
(automatically covered upon market introduction but at a rebated price) to
evaluation of their additional therapeutic benefit; new drugs that do not
demonstrate additional benefit are assigned to a reference price group after six
months; prices of drugs with additional benefit are negotiated based on the degree
of benefit and are applied from the 13th month after market introduction.
User charges
• Quarterly co-payment of €10 for GP and outpatient specialist visits abolished
because of the large surpluses accumulated by the SHI system (2012).
Changes to health service planning, purchasing and delivery
Prices of medical goods
• No response reported.
Salaries and motivation of health sector workers
• Adjustments to the reimbursement of ambulatory physicians were frozen
(2011, 2012), but an additional €1 billion was negotiated in 2011.
Payment to providers
• Reimbursement of psychiatric hospitals under a DRG-like system. The
reimbursement rates are updated annually (by way of negotiations) (2013).
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• No response reported.
Provider infrastructure and capital investment
• No response reported.
Priority setting or protocols to change access to treatments, coordination
of care and patterns of use
• No response reported.
Waiting times
• No response reported.
Health promotion and prevention
• No response reported.