About Additional Benefit Assessment Conducted by the German Federal Joint Committee (G-BA) and Statutory Health Insurance
Clinuvel Pharmaceuticals Ltd (ASX: CUV) has reached an agreement with the German National Association of Statutory Health Insurance
Funds (GKV-Spitzenverband or GKV-SV) for the pricing of Clinuvel's drug Scenesse (afamelanotide 16mg) for the treatment of erythropoietic protoporphyria (EPP) patients, the company disclosed on Wednesday.
The price of the statutory health insurance
plan depends on earnings; the price of private health insurance depends on risk.
* separate institutional responsibility for ambulatory services (the associations of statutory health insurance
physicians) and stationary provision (the federal states), which led to a fragmentation of care and reduced the performance of the health care system as a whole;
In response, the Federal health authority outlined structured disease management programs under the responsibility of the statutory health insurance
companies and regulated the admission to such programs.
The German government's Statutory Health Insurance
saved approximately 1.8 billion [euro] in 2001 due to indirect price controls through reference prices.
The former comprise all statutory health insurance
funds (Gesetzliche Krankenkassen, GKV) and regional associations of doctors and dentists (Kassenarztliche Vereinigungen, KV and an equivalent organisation for dentists) whose members practice under contract to the health insurance funds.
Officially introduced in 1883 by Chancellor Bismarck, statutory health insurance
, in the beginning, only covered workers and was restricted to specific types of services, mainly cash benefits in case of sickness.
This move will allow the company to be eligible for reimbursement under the statutory health insurance
Competition between statutory health insurance
funds has been established by the introduction of free choice of sickness funds for the insured.