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Non-evidence-based services in statutory health insurance: Risky cost driver

Statutory health insurance (GKV) in Germany finances services from special therapy directions that are medically not or insufficiently evidence-based. These include homeopathic treatments and medications, anthroposophical approaches, and phytotherapeutic preparations. These directions are recognized in the German Drug Act (Arzneimittelgesetz) as special therapy directions and are subject to lower requirements for proof of efficacy than conventional medications. The Joint Federal Committee does not review them within the same strict framework as standard benefits. Instead, health insurance companies can reimburse them voluntarily as supplementary benefits, through selective contracts, or in optional tariffs and bonus programs. The scientific consensus sees no effect beyond the placebo effect for these methods, or only traditionally based effects without sufficient modern randomized controlled trials for broad applications. Nevertheless, numerous insurance companies use these offers to differentiate themselves in the competition for policyholders and to meet demand. The legal basis for these reimbursements lies in the Social Code Book V and the Drug Act. Since the 2007 health reform…

Antibiotic use below pre-pandemic levels

In 2022, a total of 31 million prescriptions for antibiotics, worth 733 million euros, were billed to statutory health insurance (GKV). This corresponds to almost every 25th outpatient prescription in the GKV. The share of reserve antibiotics remained at a similar level to the "Corona years" of 2020 and 2021 at 42 percent, and about 5 percent below the prescription share of 2019. The WIdO has recorded declining prescription numbers for these active ingredients since 2013.