The German federal ministry of justice and consumer protection has published a draft bill (link in German) that aims to tackle corruption in healthcare.
Currently, it is not illegal to offer gifts or other benefits to private-practice doctors, which includes most doctors working in outpatient care in the country. This is because a ruling two years ago by the German federal court of justice said that existing anti-bribery laws only applied to employees or agents of a business or public officials.
Private-practice doctors do not fall under either category, according to a newsletter issued by Leslie Galloway, chairman of the Ethical Medicines Industry Group.
The draft bill says that: "any healthcare professional who asks for an advantage for himself or a third party or accepts the promise or accepts such advantages in return for unfairly preferring a certain manufacturer or violates his professional duties in another way in connection with the purchase, prescription, administration or dispense of medicines or medical devices shall be liable for imprisonment up to three years or a fine; and, anyone who is offering, promising or granting such advantages to healthcare professionals shall be liable to the same punishment."
This applies to all healthcare professionals including nurses, speech therapists and physiotherapists, Galloway said.
Germany's government has already agreed to amend the code on bribery in healthcare, so the new law is likely to be adopted within the next year, Galloway said.
This does not come as a big surprise, said Munich-based compliance expert Michael Reich of Pinsent Masons, the law firm behind Out-Law.com, "since it was part of what the coalition government announced it would do when it took over in 2013. If they have not already done so, manufacturers of pharmaceuticals or medical devices should closely review all existing cooperation agreements that are in place with private practitioners in all healthcare professions."
There is no minimum limit on the rules, but "small and generally accepted promotional gifts or presents from patients … are not suited to influence professional decisions" and therefore do not fall under the provisions of the new code, he said.
In an interview with the Stuttgarter Nachrichten (link in German) newspaper earlier this month, parliamentary state secretary to the federal minister for justice and consumer protection Christian Lange said that patients have to be able to trust their doctors.
Lange worked with health professional groups, the pharmaceutical industry and law enforcement to create the draft bill, the ministry said in a statement last year (link in German).
"There are estimates that this causes annual losses of about €10 million (US$10.7 million), and a health insurance survey from 2012 suggests that 14% of doctors in private practice had been paid [by suppliers]," Lange said in the interview.
The problem is broader than just doctors prescribing drugs, Lange said. Doctors have been paid for giving fictitious lectures, and purchasing decisions in nursing homes and hospitals have been influenced by grants from manufacturers.
Reactions to the changes from the medical profession have been very positive, Lange said. Honest practitioners are annoyed by being associated with "a few black sheep".