Reframing Pharmaceutical Pricing: Implications of the 2025 SVR Report for Germany’s Pricing Logic and International Spillovers
Author(s)
Stefan Walzer, MA, PhD1, Lutz Michael Vollmer, MSc1, Dingeman Wolfert, BA, MSc2, Anne M. Loos, MA3, Eddie Gibson, DPhil4.
1MArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Germany, 2Wickenstones Ltd, London, United Kingdom, 3Wickenstones, Charlestown, MA, USA, 4Wickenstones Ltd, Leek, United Kingdom.
1MArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Germany, 2Wickenstones Ltd, London, United Kingdom, 3Wickenstones, Charlestown, MA, USA, 4Wickenstones Ltd, Leek, United Kingdom.
OBJECTIVES: The 2025 SVR report recommends a fundamental shift in Germany’s approach to pharmaceutical pricing—moving from negotiated value discussions toward more structured, externally anchored price formation mechanisms. These include interim prices based on comparator therapies, budget caps, dynamic price adjustments, and the increased use of cost-effectiveness information. Given Germany’s role as a reference country in many international pricing systems, these reforms carry significant implications beyond national borders.
METHODS: This policy analysis synthesizes chapters 2 and 5 of the SVR report with comparative HTA and pricing frameworks from France, the UK, Canada, and the Netherlands. Implementation barriers and spillover effects were assessed using international price referencing models and existing literature on launch sequencing and market access delays.
RESULTS: The proposed reforms include: (1) externally set interim prices tied to the appropriate comparator (zVT); (2) dynamic price revisions based on new evidence or comparator changes; and (3) potential budget thresholds with automatic rebates. These mechanisms aim to increase system sustainability and negotiation symmetry. However, since Germany serves as a price reference in more than 25 countries, any downward pressure on German prices could trigger global ripple effects, potentially leading to launch delays, especially in smaller markets. Furthermore, rigid pricing logic may reduce manufacturer flexibility, affecting early market access and product positioning strategies.
CONCLUSIONS: The SVR proposals aim to strengthen pricing logic and control costs but risk unintended consequences for global market access. Active stakeholder engagement with German and EU policymakers is essential to align evidence, incentives, and international dependencies. Additionally, the shift toward greater transparency raises questions about long-term pricing strategy. A return to confidential net pricing may help mitigate global spillovers and protect launch flexibility. Coordinated implementation and safeguard mechanisms are needed to ensure that innovation and access are not compromised by rigid pricing reforms.
METHODS: This policy analysis synthesizes chapters 2 and 5 of the SVR report with comparative HTA and pricing frameworks from France, the UK, Canada, and the Netherlands. Implementation barriers and spillover effects were assessed using international price referencing models and existing literature on launch sequencing and market access delays.
RESULTS: The proposed reforms include: (1) externally set interim prices tied to the appropriate comparator (zVT); (2) dynamic price revisions based on new evidence or comparator changes; and (3) potential budget thresholds with automatic rebates. These mechanisms aim to increase system sustainability and negotiation symmetry. However, since Germany serves as a price reference in more than 25 countries, any downward pressure on German prices could trigger global ripple effects, potentially leading to launch delays, especially in smaller markets. Furthermore, rigid pricing logic may reduce manufacturer flexibility, affecting early market access and product positioning strategies.
CONCLUSIONS: The SVR proposals aim to strengthen pricing logic and control costs but risk unintended consequences for global market access. Active stakeholder engagement with German and EU policymakers is essential to align evidence, incentives, and international dependencies. Additionally, the shift toward greater transparency raises questions about long-term pricing strategy. A return to confidential net pricing may help mitigate global spillovers and protect launch flexibility. Coordinated implementation and safeguard mechanisms are needed to ensure that innovation and access are not compromised by rigid pricing reforms.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR171
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas