The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) GKV-SV issued a decision on 26 January 2026 to raise reference prices for certain dosage forms within established therapeutic clusters. This measure – enacted under Paragraph 35 Section 5b of the Social Code Book V (Fünftes Buch Sozialgesetzbuch) SGB V – specifically targets non-prescription medicines (verschreibungsfreie Arzneimittel) that remain subject to statutory reimbursement limits.
The GKV-SV uses this mechanism to prevent supply bottlenecks for essential over-the-counter (OTC) therapies. Previously, these products faced rigid price ceilings that did not always account for inflationary pressures on active pharmaceutical ingredients. By adjusting the German Reference Price (Festbetrag) upwards, the association allows for higher pharmacy selling prices without increasing the financial burden on patients through additional out-of-pocket 'co-payments'.
The new rates will take effect on 15 March 2026. This technical update follows the association's regular monitoring of market availability and production overheads. Data suggest that maintaining these specific price floors is necessary to ensure that manufacturers continue to supply the German market rather than withdrawing low-margin products.
This decision prioritises supply resilience over immediate cost-containment within the OTC segment. It signals an institutional recognition that price floors must remain flexible to sustain a diverse manufacturer base. The move reduces the risk of mandatory product substitutions and ensures stable access to non-prescription therapies within the statutory health insurance (Gesetzliche Krankenversicherung) GKV framework.
Source: GKV-Spitzenverband
Link: Festbetragsanhebung nach § 35 Abs. 5b SGB V zum 15.03.2026 (Reference price increase according to § 35 Para. 5b SGB V as of 15 March 2026)
Date: 26 January 2026
