Disagreement between the DAV and the National Association of Statutory Health Insurance Funds: How should the billing of prescription substances be handled?

Disagreement between the DAV and the National Association of Statutory Health Insurance Funds: How should the billing of prescription substances be handled?

According to a report by www.deutsche-apotheker-zeitung.de,

,

The disagreement between the German Pharmacists Association (DAV) and the National Association of Statutory Health Insurance Funds regarding the billing of prescription substances still exists. While the DAV provides for the entire package to be billed, the National Association of Statutory Health Insurance Funds believes that only the portion that is actually processed can be billed. Now the Barmer health insurance company, one of the largest health insurance companies in Germany, has agreed with the opinion of the National Association of Statutory Health Insurance Funds and made this clear in a letter to the pharmacies.

This decision by Barmer has potentially far-reaching effects on pharmacies and the pharmaceutical industry. By only being able to bill for the portion of the pack that is actually processed, pharmacies could make do with lower income in the future. Since Barmer also refers to the cost-effectiveness requirement in Book V of the Social Security Code in her letter, this could lead to increased pressure on pharmacies to work cost-efficiently and waste as little medication as possible.

The financial impact on the pharmaceutical industry could also be significant. Pharmacies may be forced to adjust their purchasing practices and potentially purchase smaller pack sizes to meet Barmer's billing requirements. This in turn could lead to changed supply and demand conditions on the pharmaceutical market.

Overall, it can be assumed that Barmer's decision to adopt the view of the National Association of Statutory Health Insurance Funds will lead to a change in business practices in the pharmacy sector and the pharmaceutical industry. It remains to be seen whether other health insurance companies will take similar measures or whether this will remain a specific approach by Barmer.