Representation of companies before the arbitration board when no agreement on the price could be reached in the AMNOG procedure, and representation of the arbitration board before the Federal Social Court (BSG)

Challenge

If pharmaceutical manufacturers cannot reach an agreement on the price of a drug with the National Association of Statutory Health Insurance Funds, the procedure continues before the arbitration board. Thus, criteria for price formation that are supported by the majority in the arbitration board must be found. In the worst case, the company decides to withdraw the product from the market, making it no longer available to patients.

Solution

Dierks+Company represents pharmaceutical manufacturers before the arbitration board and negotiates acceptable contractual conditions and a majority-supported pricing model.

Dierks+Company also took on the legal representation of the arbitration board in a revision process before the Federal Social Court (BSG). The issues specifically concerned the permissibility of mixed pricing and the competencies of the arbitration board.

Benefit

If the arbitration negotiations conclude successfully for the company, the product can remain on the market at an acceptable price and continues to be available to patients.

The revision process was won at the Federal Social Court. The judgment declared mixed prices permissible and granted the arbitration board extensive competencies in setting reimbursement amounts.

Contribution D+C

Dierks+Company has successfully negotiated in complex matters, also with an understanding for the opposing side. They developed good and differentiated arguments that convinced the arbitration board (and the BSG) – with tough but fair negotiating skills.

Prof. Dr. Jürgen Wasem
Professor of Health Care Management at the University of Duisburg-Essen

“I have experienced Christian Dierks as a well-prepared, skilled, and flexible negotiator. Therefore, the arbitration board decided to be represented by Dierks+Company in an important negotiation before the Federal Social Court. We entered the proceedings not only with well-crafted written submissions, but Christian Dierks also demonstrated in the oral hearing how well he could present arguments at the right time to convince the senate.”

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