Mar 25 2020

For the first time, the AMNOG seriously tackles the price monopoly of 1 January onwards for eligible new pharmaceuticals launched on. Since its introduction on January 1, , AMNOG has hampered the market access of some products in Germany such as Trajenta (anti-diabetic) and Retigabin. AMNOG is here to stay. However, all this changed at the beginning of AMNOG, meanwhile, sought to achieve a longer-term reduction of drug prices.

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Ipilimumab’s benefit on mortality was originally considered to be major.

AMNOG – evaluation of new pharmaceutical – GKV-Spitzenverband

Guideline on the evaluation of anticancer medicinal products in man. If no added benefit can be determined, a reference price is allocated to the new drug or a price that is not allowed to be higher than that of the comparator therapy. Archives of Internal Medicine— Pharmaceutical companies may expect in future to receive a suitable refund rate for real innovations. This is however only possible at the earliest one year after publication of the resolution on the early additional benefit evaluation.

It would be an exaggeration to portray this withdrawal of the pharmaceutical companies as a risk that Germany might no longer be supplied with modern medicinal products. This creates a significant challenge for the manufacturer. We understand products to be innovative which tangibly improve patient care.

Until the AMNOG procedure has been completed, the price set by the pharmaceutical company itself applies to the new pharmaceutical for one year. Guide to methods of technology appraisal The approach has been criticized by some researchers e.

First, regulatory approvals for conditions with unmet medical needs may be based solely on single arm studies.

Recherche en Soins Infirmiers25— Price negotiations take place during the second phase. The new medicinal product must take this as amjog benchmark. Pharmaceutical expenditure will be limited by wmnog refund rates that are negotiated under the AMNOG procedure. Germany is typically prioritized by the pharmaceutical industry: Both statutory and private health insurers can presume in future that high refund rates are indeed countered by a corresponding additional benefit for patient care, and that they do not have to finance spurious innovations which all too frequently are excessively expensive, as they used to have to.


This downgrading was also due to additional information from the commenting procedures at the G-BAwhich are routinely conducted after completion of the dossier assessments. New response evaluation criteria in solid tumours: These also stipulate that the expedient comparative therapy which in each case was determined by the resolution of the Federal Joint Committee, and its annual therapy cost, are considered to be the most important aspects.

C requires an interaction test. A medicinal product which wishes to distinguish itself from the expedient comparative therapy must exceed the benefit of this therapy, that is it must have an additional benefit in the stated categories.

This will be taken into consideration during price negotiations. Appendix II is of particular importance to pharmaceutical companies.

AMNOG – evaluation of new pharmaceutical

Annog AMNOG provides for the benefit assessment of reimbursable pharmaceuticals with new active ingredients based on proof provided by the pharmaceutical company. For companies in Germany, planning for extensive subgroup analysis will become essential to be prepared for contingencies with limited reimbursement. This resolution of the Federal Joint Committee is published.

These statutory stipulations are complied with by the Federal Joint Committee by submitting a separate dossier for medicinal products that are comparable with fixed-rate medicinal products in pharmacological and therapeutic terms Annex VI to the 5th Chapter of the Rules of Procedure of the Federal Joint Committee. This could translate to a lower power to detect a hazard ratio that is less than one at a fixed significance level.

The dossier was forwarded to IQWiG for assessment. Hint weakest certainty of conclusions: Biometrical Journal this issue.

Such medicinal products will have to put up with being in the second or third row in future — including when it comes to price. Please use the following address on the outside envelope: It was already obvious in that not only were additional internal resources required to prepare AMNOG reports, but also external ones in the form of experts from all medical fields.

The actual comparative European prices and the annual therapy costs of comparable medicinal products are only then used as further criteria. Focusing on the first phase, this paper investigates requirements of benefit assessment of a new product under this law with special attention on the methods applied by the German authorities on issues such as the choice of the comparator, patient relevant endpoints, subgroup analyses, extent of benefit, determination of net benefit, primary and secondary endpoints, and uncertainty of the additional benefit.


It includes three appendices: External experts It was already obvious in that not only were additional internal resources required to prepare AMNOG reports, but also external ones in the form of experts from all medical fields.

Implementation of AMNOG: An industry perspective

Pharmaceutical companies can send any questions they may have regarding the G-BA consultation procedure to the following email address: At federal level, the negotiated refund rate may be followed by selective contracts between individual health insurance funds or their associations, and the pharmaceutical companies.

If the additional benefit is less than that of the expedient comparative therapy, the National Association of Statutory Health Insurance Funds stipulates a deduction. Lower expenditure on medicinal products with no additional benefit means that the probability of additional contributions and contribution increases falls. The legislature has tasked the National Association of Statutory Health Insurance Funds with ensuring that new patented amnof products are supplied at a suitable cost to the statutory health insurance funds.

Therefore, reducing the number of events in the groups by removing a component from the composite endpoint leads to a larger variance for the manog hazard ratio estimate and a wider confidence interval for the log hazard ratio. Composite endpoints that have been traditionally used as the primary endpoints in many large registration trials can now be questioned by IQWiG. The Federal Joint Committee plays a major role through the early benefit evaluation.

Journal of the American College of Cardiology 52— All resolutions that are adopted, including the summary scientific and legal evaluation, the discussions, as well as the debate with the arguments put forward in the statement procedure, are retrievable 20011 the Internet site of the Federal Joint Committee. Major criteria are improving the state of health, shortening the period of illness, extending survival, reducing side-effects or improving quality of life.

On the rare occasions when a component of a composite endpoint is removed, we propose in Section 2.