With the introduction of the German Pharmaceutical Market Reorganisation Act (German: “Arzneimittelmarktneuordnungsgesetz” (AMNOG)) in January 2011, pharmaceutical entrepreneurs have to present a dossier to demonstrate the additional benefit of a new pharmaceutical at product launch in the German market. Pharmaceuticals failing to demonstrate additional benefit against the standard of care in the corresponding indication can be included in an existing reference price group or even trigger the building of a new one. Top-selling reference price markets with many newcomers or price-aggressive competitors are at risk of a repeated examination through the federal joint committee (G-BA) in short intervals, resulting in a frequent updating of the reference price. This triggers a cascade, the so called “Kellertreppeneffekt” (Race to the Bottom), which could result in a rapidly decreasing reference price. One parameter of interest to assure an adequate security of supply is the measure value 160, assuring that at least 20% of packages and 20% of prescriptions are available at a lower price than the new reference price. To avoid the cascade, alternative, lower measure values, such as the measure value 100, can be applied. The measure value 100 is feasible for reference price groups with a large amount of products which are free of patients’ copayment. Pharmaceuticals are normally free of patients’ copayment if the product price is 30% lower than the corresponding reference price. The focus of our presentation is to analyze the impact of the AMNOG on 10 top-seller reference price groups and to evaluate further adjustments to the reference price level of these groups through varying measure values. Furthermore, additional parameters of interest influencing the reference price level will be considered.