The chapter on health and nursing is one of the most extensive in the 147-page coalition agreement. In addition to key statements on care, emphasis is repeatedly placed on pharmaceutical, biotech and medtech issues. The coalition agreement thus addresses a large number of health policy issues. The German government is planning comprehensive health care reforms – with a focus on prevention, digitalisation, quality of care and Germany’s attractiveness as an investment location.
Much related to these reforms is still unclear. The details of the plans will be revealed by the legislature's actions. Companies in the health care sector see it as a positive signal that priorities are being set both in the health care industry and in health care provision and that plans are being made to improve the health care landscape in Germany.
In the following, we will provide an initial overview of the key contents of the coalition agreement.
Pharma and medtech: Innovation, security of care and market access
The government wants to significantly strengthen the industrial health care sector. The pharmaceutical industry and medical technology are acknowledged as "leading industries", as the coalition agreement puts it. They are therefore gaining considerable weight in the economy as a whole and are likely to become an even greater focus of economic policy-making.
The government is focusing on continuity in its dialogue with the pharmaceutical industry and its pharmaceutical strategy. The goal is for Germany to become the world's most innovative chemical, pharmaceutical and biotechnology location. The federal government wants to further improve the framework conditions for the development and production of medicinal products, active ingredients and medical devices and to further develop the National Pharmaceutical Strategy to this end. Biotechnology is to be promoted as a key industry and its applications are to be facilitated through regulation. One of the main objectives is to facilitate access to innovative therapies. The German Pharmaceutical Market Reorganisation Act (AMNOG), along with other legislation, is to be further developed for this purpose, in particular to promote personalised medicine – a field with great market potential.
These measures are intended to give companies the opportunity to strengthen their innovative power and benefit from improved market accessibility. The relocation of production sites for critical medicinal products and medical devices back to Germany and Europe should increase security of supply. This can be particularly advantageous for companies that are able to adapt their production quickly and benefit from the new location advantages.
Hurdles in clinical research are to be removed. In addition, corresponding regulations, for example in the area of CAR-T cell therapies, are to be harmonised. Companies that invest in research and development could benefit from a possible accelerated market launch of new products. At the same time, adapting to new regulatory frameworks may require careful planning and implementation to ensure compatibility and minimise potential risks.
Hospital reform: Greater quality through structural change
The government is committed to further developing a high-quality, needs-oriented and practical hospital landscape that builds on the hospital reform from the previous legislative period. This is to be finalised in the short term, by summer 2025.
The hospital landscape is therefore set to be further developed in line with the hospital reform that has already begun – with a focus on basic and emergency care, particularly in rural areas. New financing models and cross-sector flat rates per case (hybrid DRGs) are expected to promote efficiency and cooperation. They are intended to provide the opportunity to organise care more flexibly and use resources more efficiently.
For clinics, this will mean that processes will have to be optimised, cooperation with outpatient providers can be expanded and remuneration structures will have to be rethought – in close cooperation with the funding bodies.
Outpatient care: Primary care system and relief
Outpatient care is to be improved through targeted measures. Concrete steps are planned to reduce the workload for doctors' surgeries and shorten waiting times. A mandatory primary doctor system is expected to ensure targeted care. Exceptions apply to gynaecology and ophthalmology. Individualised solutions such as annual referrals are to be developed for chronically ill patients.
Investor-operated health care centres (iMVZ): Focus on transparency obligations
One of the most concrete statements in health care relates to investor-operated health care centres (iMVZ). The coalition agreement states that the government will adopt a law to regulate investor-operated health care centres (iMVZ Regulation Act), which will ensure transparency regarding the ownership structure and the proper use of financing. This would seem to resolve an issue that has been the subject of controversy for a long time, in that it is no longer up for debate whether health care centres may also be operated by investors and instead the primary questions are about transparency and organisation. For investors, this can mean greater requirements for disclosure and internal governance. At the same time, the greater transparency should increase the trust of patients and the public in investor-operated health care centres (iMVZ). The specific statements on investor-operated health care centres (iMVZ) in the coalition agreement indicate that a far-reaching restriction on the authorisation of investor-operated health care centres (iMVZ), as was considered in the past, is not expected to be implemented for the time being.
Pharmacies: Strengthening local pharmacies
Local pharmacies are to be strengthened as the first point of contact for health care. The ban on third-party ownership is to be reaffirmed and pharmacies in rural areas in particular are to be supported. The ban on discounts is to be abolished. Structures for preventive services are to be expanded and bureaucratic hurdles removed. The requirements for local pharmacies and mail-order pharmacies are to be standardised.
Digitalisation and telemedicine: Reducing barriers and expanding opportunities for cooperation
The government sees digitalisation as the key to the future of health care. A planned law to reduce bureaucracy will in particular reduce documentation requirements. Improved data exchange should increase the efficiency of health care, including in preventive health promotion. The laws in this area are to undergo a practical check in order to review their efficiency.
Digitalisation in the health care sector is to be driven forward in particular by continuing to roll out the electronic patient records and by improving the framework conditions for telemedicine in video consultations, telemonitoring and telepharmacy.
If the government actually implements the corresponding plans, this could give a further boost to digitalisation in the health care sector. Expanded or new areas of activity may emerge for companies in this field as a result, for example in the area of telemedicine. At the same time, the new coalition also appears to be interested in restricting existing business areas in certain sectors. For example, issuing certificates of incapacity for work via private online platforms is to be excluded.
Cannabis
An open-ended evaluation of the law legalising cannabis is planned for the autumn of 2025. Depending on the results, this could lead to new economic options.
Crisis-proof care
The government intends to create a legal framework for the health care sector and emergency services for cases of civil defence, military defence and alliance emergencies to ensure that there is well-managed coordination and that responsibilities are clearly defined. This shows how interlinked the health sector is with civil and military defence policy.
Conclusion: Health policy as a driving force
Health care plays an important role at various points in the coalition agreement. The government recognises the central role of this sector in terms of both economic policy and society as a whole.
Much of the content remains rather vague and anyone looking for statements on specific measures or clear concepts will only find them in a few places. This makes it all the more important to see what concrete steps the new health minister and the federal government will take in the various fields. For companies in the health care industry – both industrial health care companies and service providers – it is clear that their sector will become even more important in the future than it has been to date. On the one hand, this will open up a wide range of opportunities, but on the other, it will probably also require structural adjustments in view of the costs of the health care system and the efficiency gains required.
It will be crucial to keep a close eye on health policy and legislative activities, intervene where necessary and adapt to changes at an early stage. Those who stay on their toes will benefit from the imminent changes and be able to strategically align themselves accordingly.
