Germany was the first country in Europe to introduce a reference price system. In 1989 it implemented the so-called ‘Festbetragssystem’, which over time has been adapted. Today, it is accompanied by obligatory generic substitution ‘Aut-idem-Regelung’ and practice-specific prescription volume target agreements for doctors.

From 1993 to 2001, pharmaceutical budgets, which were organised differently (regional budgets, possibility for sanctions etc.), were applied. These pharmaceutical budgets were replaced by today’s target agreements with the prescribing doctors, which take the characteristics of the doctor’s practice into account. The target agreements are connected to financial sanctions. If the prescription volume target is exceeded by 25%, doctors have to re-pay overspending.

A scientific institute from a sickness fund, Wissenschaftliches Institut der Ortskrankenkassen (WldO) monitors pharmaceutical expenditure and consumption. A key information tool is a report analysing the development of pharmaceutical prescriptions ‘Arzneiverordnungs-Report’, which has been published on a yearly basis for the last 25 years.

Acknowledgement

This article is published with permission of the Gesundheit Österreich GmbH (GÖG)/Austrian Health Institute.

We gratefully acknowledge the support from Dr Sabine Vogler of Gesundheit Österreich GmbH / Österreichisches Bundesinstitut für Gesundheitswesen (GÖG/ÖBIG – Austrian Health Institute) to GaBI Online.

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Reference

Vogler S, Schmickl B. Rational use of medicines in Europe. Gesundheit Österreich GmbH / Österreichisches Bundesinstitut für Gesundheitswesen (GÖG/ÖBIG). February 2010.