States Urged to Monitor Prescription Bonuses

The Parliamentary State Secretary in the Federal Ministry of Health, Tino Sorge, has emphasized that it is the responsibility of the states to enforce regulations against violations of the drug price binding law. This comes in light of a recent ruling by the Federal Court of Justice regarding an old bonus model from the Dutch online pharmacy Doc Morris, which has led to an increase in discount promotions from various Dutch suppliers, despite a prohibition on bonuses under the Social Code Book V.

Federal Health Minister Nina Warken has publicly stated her view that online suppliers are also bound by social law regulations. In response to a minor inquiry from the AfD party, State Secretary Sorge reiterated this stance, underscoring the importance of maintaining uniform pharmacy prices for insured patients. He argued that this is both socially and health-politically necessary to ensure the proper functioning of the billing process between pharmacies and statutory health insurance within the framework of the benefit principle.

Sorge pointed out that offering prescription bonuses constitutes a violation of the German Medicines Act (AMG) and the Social Code Book V (SGB V). He referred to § 129 paragraph 4 sentence 4 of the SGB V, which stipulates penalties for serious or repeated violations. Additionally, he noted that offering illegal bonuses is also a breach of the German Medicines Advertising Act (HWG), which could result in fines of up to EUR50,000.

However, Sorge clarified that it is not the federal government but the respective state authorities that are responsible for enforcing the HWG regulations. He also mentioned that since the HWG regulations are considered market conduct rules under the Act Against Unfair Competition (UWG), claims can be pursued through competition law proceedings.

Despite acknowledging the illegality of such bonuses, Sorge made it clear that the responsibility for monitoring lies with state authorities. He reaffirmed that offering discounts on medicines by both local pharmacies and online suppliers in violation of existing price regulations constitutes a clear breach of the HWG.

This situation follows a 2016 ruling by the European Court of Justice (ECJ) which determined that the previous German price binding regulation did not apply to foreign suppliers. In response, the legislator modified the Rx bonus prohibition, moving it to § 129 paragraph 3 sentence 3 of the SGB V.