Medical care centers: Transparency and regulation
Investor-owned medical care centers (iMVZ) have long been a subject of political debate in Germany. Potential restrictions on iMVZ have been discussed regularly over the last years. The coalition agreement contains plans to establish a law for the regulation of these medical care centers. This law is specifically supposed to increase transparency regarding the ownership structure of investor-owned medical care centers and to ensure the “appropriate use of funds”.
Although the language remains vague, these proposed measures appear less far-reaching as previously discussed restrictions, which included geographic limitations, quotas, or the general prohibition of investor-owned medical care centers as demanded by the former German Health Minister Karl Lauterbach (SPD). Therefore, investments in medical care centers could – at least from a legal standpoint – remain a promising opportunity, which of course depends on the further course of the future legislative procedure.
Hospital reform: A structural shift
During the previous legislative period, the former health minister has initiated the hospital reform, which the new government intends to finalize by summer 2025. The hospital reform particularly intends to change the remuneration system of hospitals. Instead of the current remuneration system of DRG-based flat-rate fees, hospitals will receive most of their remuneration for providing or maintaining certain services (Vorhaltepauschalen). Hospitals will be grouped into defined “service groups” that determine the services they can offer. The coalition agreement provides for some adjustments and possible deviation options for the federal states, with the new remuneration system aiming to be implemented after a three-year convergence phase in 2027. This structural change is expected to have a profound impact on hospital planning, specialization and regional care strategies.
Digitalization: Unlocking the potential of HealthTech
The new government is placing a high priority on the digital transformation of the German healthcare sector, as underscored by the creation of a new federal ministry for digitalization. Building on existing initiatives like the rollout of the electronic patient file (Elektronische Patientenakte), the coalition agreement contains a broader strategy to improve the framework for the use of telemedicine, digital solutions and seamless data interoperability. This includes planned investments in the digitalization of the hospital, university clinic and care infrastructure as well as opportunities for AI-supported treatment and care documentation. For investors, this push for digitalization could unlock significant growth opportunities – especially in areas like telemedicine, software, AI, medical data platforms and connected devices. Germany´s fragmented digital health ecosystem may finally receive the structural support and help to position Germany as a key player in the field of HealthTech.
Pharmaceutical research and production: Strengthening Germany as a pharma and biotech location
Over the last years, several measures have been implemented to increase Germany’s attractiveness as a location for pharmaceutical research and production through the pharmaceutical strategy and the German Medical Research Act (Medizinforschungsgesetz). The new government intends to continue this approach and take further action to promote Germany’s competitiveness as a
business location for research, production and innovation while even aiming to establish Germany as one of the world’s most innovative chemical, pharmaceutical and biotechnology hubs. In particular, the aim is to improve the framework conditions for the research and development as well as the production of pharmaceuticals, active ingredients and medical devices. Additionally, a national biobank will be established as a basis for preventive, precision, and personalized medicine.
It remains to be seen what measures the new government will implement and whether there will be sufficient incentives for the pharmaceutical industry to relocate or expand their activities to Germany. If successful, the proposed reforms could significantly boost Germany´s competitiveness on the global stage and open attractive opportunities across the life sciences value chain.
Funding of Statutory Health Insurance (SHI): Cost savings and reforms
Securing the financial sustainability of the SHI without further increasing the contribution rates is a priority of the new government. While revenues shall be increased by higher levels of employment, expenses shall be reduced in parallel. The coalition agreement does not specify concrete measures at this stage, but a dedicated expert commission will be tasked to propose concrete measures by 2027.
According to the coalition agreement, the AMNOG procedure for assessing new pharmaceuticals will be further developed and refined to secure access to innovative therapies, but also to maintain cost efficiency. In particular, the coalition agreement mentions a refinement of the "guardrails" introduced with the Statutory Health Insurance Financial Stabilization Act (GKV-FinStG) in 2022 to closely link the additional benefit of a new therapy method and the SHI reimbursement amount paid for it. These upcoming changes may intensify cost pressure on pharmaceutical companies.
Cannabis: Further evaluation
The former government had passed a partial legalization of cannabis, which came into effect in 2024, allowing the consumption of cannabis as well as private home cultivation and communal, non-commercial home cultivation of cannabis in cultivation associations. While CDU and CSU clearly advocated for a reversal of this partial legalization of cannabis during the election campaign, the coalition agreement only foresees an open-ended evaluation of the law in autumn 2025. However, at least further legalization (e.g., of commercial sale) is unlikely to be pursued under the new government.
Pharmacies: Strengthening local infrastructure
The coalition agreement sets a focus on strengthening local pharmacies in Germany. This includes a one-time increase in remuneration of pharmacies. Furthermore, the new government aims to further enable cash discounts granted by pharmaceutical companies or wholesalers to pharmacies – a practice that was heavily restricted by a decision of the German Federal Court of Justice (BGH) in 2024.
Within the scope of strengthening local pharmacies, regulations for local pharmacies and mail-order pharmacies are supposed to be harmonized, with specific reference to cool chain logistics and documentation requirements. It remains to be seen whether this will lead to further restrictions of mail-order pharmacies. The ban on third-party ownership will remain in force, so that external investors will continue to be excluded from owning or holding stakes in pharmacies.
Conclusion: High aspirations, unclear implementation
While the coalition agreement emphasizes the significant role of the healthcare sector in Germany and addresses many important points, it remains rather unclear and vague in several aspects. The coalition agreement primarily contains legislative proposals and descriptions of objectives and only a few specific projects. Therefore, the exact impact of the coalition agreement is still depending on its concrete implementation. It will also depend on the priorities of the future Health Minister, Nina Warken (CDU). Stakeholders in the healthcare sector should closely monitor how these aforementioned plans translate into action and be prepared to seize the opportunities that may arise.
