Pricing & Reimbursement
Since 2011, when the AMNOG legislation came into effect in Germany, the reimbursement price for your newly launched innovative drug has to be negotiated with the German National Association of Statutory Health Insurance Funds (Spitzenverband der Gesetzlichen Krankenversicherung, GKV-SV). In case an additional benefit has been granted, the maximum reimbursement price should correspond to the additional benefit assessed in comparison with the pre-defined comparator therapy.
If no additional benefit has been granted, the drug will be grouped into an existing reference-price group or there will be negotiations about a maximum reimbursement price, in case no reference-price group exists.
For other European markets, drug-pricing is governed by similar limitations. advisors in healthcare offers proven tools and strategic concepts to provide support throughout all phases of pricing and reimbursement negotiations. Together with your team, we adapt the strategies to the regulatory requirements of your core markets and the specific needs of your organization.
What we can do for you
For pricing negotiations with the German National Association of Statutory Health Insurance Funds (Spitzenverband der Gesetzlichen Krankenversicherung, GKV-SV) or with individual sick funds, advisors in healthcare relies on profound market know-how and in-depth analysis to develop a strategy aimed at the realization of the highest-possible reimbursement price for your product.
advisors in healthcare supports your negotiators in preparation of pricing negotiations and may be present during negotiations upon request. In the preparatory phase, the argumentation can be fine-tuned during role-play exercises with subsequent feedback sessions.
Based on the situation in the first reference country – in many cases Germany – advisors in healthcare develops launch sequence and pricing strategies for further European markets. Market-savvy experts devise pricing-models and calculate diverse scenarios.