AOK: A third of those insured who are entitled to a medication plan

AOK: A third of those insured who are entitled to a medication plan

Many insured persons are entitled to a medication plan from October
The introduction of the right to a medication plan is likely to affect a large proportion of insured persons over the age of 75. As part of the E-Health Act 2015, a corresponding claim is provided if insured persons have to take at least three drugs at the same time. The AOK Scientific Institute (WIdO) has examined how many insured persons would be affected by this at the AOK. It became clear that a total of just under a third of the AOK insured persons met the prerequisite. The proportion was particularly high among the older insured.

The AOK explains that the right to a medication plan when taking several drugs at the same time is intended to reduce the number of deaths due to dangerous drug interactions. Patients who are prescribed three or more medications at the same time are therefore entitled to such a plan from October 2016. According to the AOK Scientific Institute, this applies in particular to many older insured persons. The medication plan is usually drawn up by the family doctor, according to the AOK.

7.5 million AOK insured persons meet the requirements
According to the calculations of the WIdO, from October onwards three quarters of people over the age of 75 who are insured with the AOK will be entitled to a medication plan. According to the AOK, insureds in this age group are taking “on average five different active ingredients or combinations of active ingredients.” Starting with three simultaneous prescriptions, the prerequisites for the right to a medication plan would be met. Based on the performance data for more than 24 million AOK insured persons in 2014, WIdO has estimated that around 30 percent or almost every third insured person is entitled to the medication plan. This is almost 7.5 million insured, according to the AOK. The majority of these patients are older than 65 years.

According to the AOK, it remains open whether all eligible insured persons are actually entitled to a medication plan and the estimate is based on the drug billing data, so that the actual use and dosage of the medication need not automatically be the same. But it becomes clear that the general practitioner can incur considerable effort here.

Claim the medication plan
The medication plan will initially only be available in paper form, according to the agreement between the National Association of Statutory Health Insurance Physicians, the Federal Medical Association and the German Pharmacists' Association in a corresponding framework agreement. The medication plan should include "information about the active ingredient, trade name, strength, dosage form and dosage as well as possible instructions for use", reports the AOK. Insured persons are recommended to make their claim in any case, in particular in order to minimize risks from possible interactions. (fp)

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