The Bundestag has passed a law on increased pharmaceutical research. It is tailor-made for an American company, says left-wing politician Kathrin Vogler.
Price fixing creates even bigger profits for pharmaceutical giant Eli Lilly Photo by: imago
taz: Ms Vogler, the Medical Research Act, which is intended to facilitate pharmaceutical research in Germany, is currently being passed in the Bundestag. Why do critics refer to it as the “Lex Lilly” or Lilly Law?
Kathrin Vogler: This law has a section that seems to have been specifically tailored to the needs of pharmaceutical giant Eli Lilly, which they allegedly received as a reward for building a new factory in Rhineland-Palatinate.
Since autumn 2009 he has been a member of the Left Party in the German Bundestag.
What exactly is it about?
To date, the reimbursement prices that companies negotiate with statutory health insurance companies for new patent-protected drugs are publicly available. The new law gives companies the opportunity to keep these prices secret.
And what does Eli Lilly gain from this?
Eli Lilly is a US pharmaceutical giant that focuses especially on the production of diabetes drugs. Here in Germany, Eli Lilly also sells the so-called slimming injection against obesity, which is not covered by health insurance companies. Now Eli Lilly wants to market the same active ingredient in Germany with a new diabetes drug. This would then be paid for by the statutory health insurance companies – and probably at a significantly lower price. And of course, Eli Lilly wants to prevent those who have to pay for this expensive weight loss injection from knowing privately the exact price of the diabetes drug.
What makes you think Eli Lilly would have had more influence on the legislation?
In April, the groundbreaking ceremony for the new Lilly plant in Alzey took place, and Chancellor Olaf Scholz said literally: “Everything we can do as a federal government to further strengthen Germany as a pharmaceutical location, we will do. I remember our telephone conversation, dear Dave Ricks. (Eli Lilly CEO, editor's note)and how many conversations he had with the Minister of Economy, the Minister of Health and the Minister of Science to set the direction of this investment.”
As an opposition politician, you naturally prick up your ears and wonder: who exactly promised this company what in return for making this investment? Now the federal government has told us who exactly discussed this point with representatives of the Eli Lilly company in the run-up to the Medical Research Act.
AND?
A very clear picture emerges. According to the federal government, there were six dates left until November 2023. Since then, seven more dates, almost all of which were related to secret awards. Obviously, the discussions were the boss's business: the Federal Chancellery was always involved, as were Economics Minister Robert Habeck and Science Minister Bettina Stark-Watzinger. This is also how we understand the change of heart of Federal Health Minister Karl Lauterbach.
Who would be there?
As early as 2016, Lauterbach claimed that such a lack of transparency would be a major threat to the development of compulsory spending on health insurance. Apparently, discussions at the highest levels meant that, against his better judgement, he could not resist including this story in his draft law.
How common are these processes in health policy legislation?
The government claims that it is normal procedure for representatives of the federal government to exchange ideas with representatives of companies and business associations. In fact, that is the case and I would not criticise it at all, because of course you always have to look at how companies are doing and what problems they are facing. But what was done beforehand with Lilly involved a very considerable effort in terms of meetings and discussions.
The federal government has also said that it has not centrally recorded all phone calls, conversations and email exchanges. So we will likely only see what the federal government cannot keep secret: conversations at the highest level, but not influence at lower levels.
It is not surprising that you, as a leftist, are critical in this regard. Are there other critical voices?
Almost all the players in the healthcare system are against it: the official health insurance companies, which fear a huge increase in drug prices. The private health insurance companies, which also fear an increase in the list prices of drugs that they must pay for and for whom implementation is a bureaucratic nightmare.
The Institute for Quality and Efficiency in Health Care, pharmacies and hospitals are against it. Wholesalers fear enormous bureaucracy and additional costs. Even the large pharmaceutical associations no longer had this on their list of demands, because the regulation only benefits individual companies.
The federal government itself claims that prices can be lowered through these confidential price agreements. There is now also a binding price discount of 9 percent if pharmaceutical companies use the secret rebate option.
I really believe that price secrecy could be an incentive for companies to significantly reduce prices in price negotiations. Because a discount on a lunar price is still a lunar price. Of course, companies take into account in advance the legal discounts that were introduced into the law at the last moment.
The federal government also notes that such confidential pricing regulations are common practice in Europe.
However, it should be noted that many European health systems base their price negotiations on what German health insurance companies pay for medicines. This means, at the same time, that this secret to protect Germany as a pharmaceutical location is an instrument that will probably make medicines even more expensive than they already are in poorer EU countries. Overall, it is also a deeply anti-European regulation.
The criticism was evidently effective, as the possibility of confidential price agreements was quickly limited to four years.
With such time limits, there is always the problem that companies that want to use this regulation bring their new drugs to market particularly quickly and aggressively in order to achieve the greatest possible market penetration within the time frame. Once a million patients take a new diabetes drug, there is no turning back.
What is your general opinion of the Medical Research Act?
I must say that there are also some nice things about it. For example, the fact that there are now new rules for studies on medicines for children was already necessary. Very few new medicines are being developed for children. But in general, what strikes us is that here economic development is taking place at the expense of those who have compulsory health insurance. This is really a novelty and overshadows this law.