Changes in revenues associated with antimicrobial reimbursement reforms in Germany

G7 policy declarations call for increased incentives for antimicrobial research and development (R&D). Governments fund push incentives like CARB-X and GARDP, while G7 countries are designing pull incentives to encourage the creation and introduction of novel antimicrobials. Germany has developed a pull incentive to increase revenues from sales of important new antimicrobials by exempting them from health technology benefit assessments and reference pricing. This paper examines Germany’s reforms and contributes to the ongoing debate about the merits of its approach in light of R&D and access issues. To produce the same impact on antimicrobial revenues as a delinked pull incentive, Germany needs to increase the volume of antimicrobials used or increase drug prices.