There is a lot of hope in the widespread use of corona rapid tests in Germany. Chancellor Angela Merkal (CDU) recently announced that the tests will be widely available in March. Health Minister Jens Spahn (CDU) plans that the tests can even be sold in supermarkets. The Germans could then test themselves for corona – not quite as reliable as in the laboratory, but safe enough to quickly detect many infections with the corona virus and prevent new chains of infection.
Antigen tests would be a game changer, especially in the school system as well as in old people’s and nursing homes. In addition to vaccination, they could be a central tool to contain the spread of the virus and enable a return to normality before Corona.
So what is in principle a good thing has been controversial between politicians, doctors and health insurers in recent weeks. Because it was about money – a lot of money. The conflict was hinted at by SPD health expert Karl Lauterbach on Wednesday evening in the ZDF talk show “Markus Lanz”. About the planned mass use of corona rapid tests, he said: “There have been fears on the part of the laboratory doctors that the number of PCR tests will go down.” Anyone who has a negative antigen test no longer has to do a laboratory test, “and therefore gave Of course there is also lobbying ”. Lauterbach was referring to the lobbying work of the laboratory doctors.
Medical laboratories receive 40 million euros per week for corona tests
In fact, it’s only been a week since the Professional Association of German Laboratory Doctors (BDL) publicly spoke out against nationwide rapid tests in Germany. “We warn against rapid tests, the danger is greater than the benefit,” said BDL chairman Andreas Bobrowski of the “Frankfurter Allgemeine Zeitung”.
It is better to do more PCR tests – also because there is a lack of trained staff to carry out antigen tests even in pharmacies. Here and during self-tests, there is a risk that the test takers do not want to hurt the patient. Bobrowski: “Unfortunately, when you swab your nose you have to cry, and the gag stimulus has to be triggered in the throat.”
What Bobrowski did not mention to the “FAZ”: The laboratory doctors in Germany earn good money with the PCR tests in the Corona crisis. The health insurance companies pay just under 40 euros per test; according to the Robert Koch Institute, between 1 and 1.2 million PCR tests per week are currently carried out in German laboratories. That makes sales of more than 40 million euros per week for the industry. In October and November of last year, the test utilization was almost 1.5 million PCR tests per week, so the industry turnover was around 60 million euros per week.
Before July 2020, the health insurance companies even paid 59 euros per PCR test – but in the first half of the year the number was only between 350,000 and 500,000 per week. That the price was reduced to 40 euros from July, which is the result of hard disputes between doctors and health insurers. In July, the National Association of Statutory Health Insurance Physicians (KBV) even filed a lawsuit against the health insurers. The National Association of Statutory Health Insurance Funds (GKV), on the other hand, speaks of an appropriate price, “which reflects the development in the laboratories from individual tests to mass tests.” Finally, fees for the prescribing doctors and a flat-rate transport fee are added to the test price.
In fact, many large medical laboratories in Germany use automated processes for evaluating PCR tests. In this way, up to five-digit numbers of tests can be evaluated per day – without incurring high personnel costs. The costs per PCR test are around 20 euros. Low enough to make good money with the corona tests. At the end of January, an industry insider told “Spiegel”: “Some laboratories deserve a Ferrari every day”
Pharmacies make money from rapid tests and FFP2 masks
But even with the rapid tests, which will often replace the PCR tests in the future, big money is at stake. Germany has already concluded framework agreements for 50 to 60 million rapid tests per month. Pharmacies are to receive nine euros for the procurement of a test, and another nine euros for carrying it out. In the meantime, the pharmacists are said to have criticized that as too little, according to government circles. Doctors should even receive 15 euros for the implementation. This means that the state incurs costs of at least 900 million to over 1 billion euros per month.
Finance Minister Olaf Scholz (SPD) is apparently ready to pay this. However, criticism of the sums comes from the budget committee of the Bundestag. The editorial network Germany (RND) quoted at the end of last week from a letter from the budgetary spokesman for the coalition factions, Eckhardt Rehberg (CDU) and Dennis Rohde (SPD): “The purchase price of 9 euros previously set for procurement does not correspond to the market prices known to us Purchase of large quantities and must therefore be reduced significantly, ”it says accordingly. “The 9 euros set for carrying out the test also seem disproportionately high compared to the time invested”.
There is also similar criticism of the remuneration set by the federal government for pharmacies of 6 euros per FFP2 masks distributed to citizens for a long time. The purchase price of the masks is sometimes only 60 cents, so the pharmacies were reimbursed far more money than the masks are worth. Nobody in the industry wanted to hear that they were making unfair profits. “There are always smart asses who claim that,” said Friedemann Schmidt, President of the Federal Association of German Pharmacy Associations, to “Spiegel” in December. “Almost all of our colleagues are currently increasing their personnel costs. And we can already see that some suppliers are charging higher prices. ”
The Federal Ministry of Health takes a different view that prices have stabilized. On February 10th, it therefore reduced the FFP2 mask remuneration to 3.90 euros. The pharmacists apparently tacitly accepted this after the clear public criticism.
Ultimately, however, there is not much left for the federal government than to accept the asking prices of doctors, health insurers and pharmacists. This is especially true in an emergency like the corona pandemic. Because the German health system is based on the principle of self-administration. In other words, the state does not have its own structures or its own personnel in the fight against the virus, but rather relies on the support of all those responsible in the health system to implement political decisions. So there are always compromises. The principle: live and let live.