AMNOG Verhandlungsverzögerungen Kostendruck
Definition
In claims adjusting for health/actuarial, AMNOG process mandates G-BA HTA then GKV-SV negotiations; guardrails from GKV-FinStG limit prices, causing settlement losses.
Key Findings
- Financial Impact: €3.7 billion annual pharma expenditure cuts; prices capped from month 7
- Frequency: Per new pharmaceutical launch
- Root Cause: Manual negotiation without real-time HTA data visibility
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Claims Adjusting, Actuarial Services.
Affected Stakeholders
Actuarial Analyst, Reimbursement Negotiator
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Papierbasierte Meldeverfahren Bußgelder
GoBD-Verstöße bei digitaler Dokumentation
Verzögerungen bei der Tarifgenehmigung durch BaFin
Bußgelder bei fehlerhaften AUZ-Berechnungen
Falsche Zinssatzannahmen durch manuelle Analyse
Versicherungsbetrug Verluste
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