Rabatte für Medikamente als Mittel der Kostensenkung

Bereits kurz nach der Wahl hat sich die Linie der Bundesregierung im Bezug auf die Kosten des Gesundheitssystems verändert, nicht zuletzt weil die neuen Führungskräfte der FDP im Gesundheitsministerium eine Sympathie gegenüber einer Gesundheitspauschale erkennen ließen. Praktisch gleichzeitig wurde von vielen gesetzlichen Krankenkassen eine „kleine Gesundheitspauschale“ für 2010 angekündigt: Den Zusatzbeitrag Krankenkasse müssen etliche gesetzliche Krankenkassen von ihren Mitgliedern erheben, wenn sie nicht tief in die roten Zahlen rutschen wollen.

Generell steht die Bundesregierung (insbesondere die FDP) unter starker Kritik: Viele glauben nicht, dass die neue Regierung die notwendige angemessene Berücksichtigung der Interessenlage aller Bevölkerungsgruppen im Blick hat. Das Stichwort „Klientelpolitik“ könnte 2010 zum Wahldesaster für die Regierungsparteien werden. Die Umfragewerte der FDP haben sich bereits halbiert.

Die Führungskräfte des von der FDP geführten Gesundheitsministeriums haben nun einen neuen Vorschlag gemacht, wie die Kosten im Gesundheitswesen deutlich reduziert werden können und sich dabei einen mächtigen Gegner ausgesucht. Durch Rabatte für Medikamente, die die Krankenkassen mit der Pharmaindustrie aushandeln sollen, könnte eine deutliche Kostensenkung erreicht werden. Denn im internationalen Vergleich sind die deutschen Preise für Medikamente vergleichsweise hoch; und die Kosten für Medikamente, die die Krankenkassen zu zahlen haben, haben sich bisher jeder Kostensenkungspolitik entzogen.

Der Grund hierfür ist einerseits eine kaum ausgebildete Konkurrenzsituation bei den Anbietern und Verteilern der Medikamente: Rabatte für Medikamente, wie es sie im Ausland unter unterschiedlichsten Bedingungen gibt, kennt man kaum in Deutschland. Vereinfacht gesagt, legen die Hersteller die Preise für neue Medikamente fest und erst nach Ablauf vieler Jahre besteht die Chance, dass Generika (Medikamente auf gleicher Wirkstoffbasis) eine preisgünstige Medikamenten-Alternative darstellen können. Aber auch für diese Medikamente gibt es selten Rabatte.

Nun will das Gesundheitsministerium Verhandlungen über solche Rabatte zwischen Krankenkassen und Medikamenten-Produzenten erzwingen, die dann die Kosten des Gesundheitssystems um Milliardenbeträge reduzieren würden. Es bleibt abzuwarten, ob eine solche Abkehr von Klientelpolitik umgesetzt wird. Nicola Kurth bezweifelt den Erfolg der Idee der Rabatte für Medikamente, denn die Medikamenten-Industrie habe keinen Druck, sich überhaupt auf Verhandlungen einzulassen.

Patienten, die bereits jetzt sehr häufig Medikamente von ihrem Arzt verschrieben bekommen, könnten mit ihrem Arzt oder Apotheker mal bei Gelegenheit darüber reden, ob es für die ausgewählten Mittel nicht auch kostengünstige Generika gibt. So könnte die Diskussion um Rabatte auch durch die Medikamenten-Verbraucher unterstützt werden.

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