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…

