Eli Lilly has announced that it will take up the option of a confidential discount in Germany for Mounjaro in Type 2 diabetes (T2D). The announcement has reignited controversies around the disputed policy, and the alleged link between its implementation and Lilly鈥檚 large new investment in Germany, announced in 2024.
Eli Lilly (US) has confirmed that it intends to take up the option of a confidential reimbursement price for its dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist Mounjaro (tirzepatide) in the treatment of T2D in Germany. This will be the first time the option has been taken up since it was introduced at the beginning of 2025, under the Medical Research Act (Medizinforschungsgesetz, MFG).
Lilly鈥檚 plan to opt for confidential pricing was first reported by German newspaper S眉ddeutsche Zeitung and the public broadcasters Norddeutscher Rundfunk and Westdeutsche Rundfunk, which referred to a communication from the company to physicians in Germany, explaining its plans and reportedly asserting that the price negotiated with the statutory health insurance (Gesetzliche Krankenversicherung, GKV) funds would be favourable for the GKV system.
The introduction of the option of confidential reimbursement prices has been highly controversial, with GKV funds particularly concerned that it would lead to a surge in reimbursement spending. It has also been controversial because of Germany鈥檚 established position as a champion of price transparency: Germany stands more or less alone as a European country in which discounted reimbursement prices of new originator therapies can be publicly accessed, and it has, until now, held out against attempts to introduce confidential pricing. It should be emphasised here that the situation is different in the case of off-patent medicines, which are predominantly subject to discount contracts between manufacturers and GKV funds, details of which are strictly confidential.
Such was the controversy around the proposal to introduce confidential pricing that in the final version of the MFG, thanks mainly to the lobbying of the GKV funds, the confidential pricing option was made so unattractive that the main pharmaceutical industry associations predicted vanishingly small interest in taking it up. The imposition of an additional 9% discount 鈥� on top of the negotiated discount 鈥� and the requirement to pay back overcharged trade surcharges and sales tax (when paying back the difference between the realised price and the publicly available higher price) made it economically unappealing.
And until now, not one single company has requested a confidential reimbursement price. The German Association of Research-Based 色界吧 Companies (Verband Forschender Arzneimittelhersteller, VFA) confirmed in an 11 July 2025 press release that no single company had opted for a confidential reimbursement price during the first half of 2025.
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By GlobalDataThe controversy does not end there. Soon after the proposal for confidential pricing was put forward as part of the early iterations of the MFG, in an article published by RedaktionsNetzwerk Deutschland (RND) 鈥� the joint corporate newsroom of the German Madsack Media Group 鈥� it was claimed that the inclusion of confidential pricing in the MFG was directly related to Eli Lilly鈥檚 decision to build a large new production facility in Alzey, in Germany鈥檚 Rhineland-Palatinate federal state. It was suggested that Lilly stood to gain in particular from having the option of a confidential reimbursement price, given that Mounjaro is approved both for T2D and obesity, and if the considerably lower price resulting from negotiations between the company and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) for the T2D indication were to be made publicly available, it would be difficult to maintain a significantly higher price for the obesity indication. In Germany, as in most other European countries, obesity therapies do not, as a rule, benefit from reimbursement.聽
In a later report in S眉ddeutsche Zeitung, it was claimed that internal government documents had been made available showing that the confidential pricing measure was included in the MFG as a condition for the decision to build the factory. The allegations were dismissed by Lilly and former health minister Karl Lauterbach, although in the meantime, the MFG has been given the widely quoted sobriquet 鈥淟ex Lilly.鈥�
Price negotiations between the GKV-Spitzenverband and the company for Mounjaro in T2D have already been concluded, according to the news website of the television news program Tagesschau, although at this stage, there is no official notification of a reimbursement price on the GKV-Spitzenverband website.
Predictably, the news of Lilly taking up the option of a confidential reimbursement price for Mounjaro has prompted numerous sensationalist reports in German media, in which Lilly is presented as having used its influence to bring confidential pricing into effect. Tabloid newspaper Bild and popular news weekly Focus both ran articles presenting this view, both also presenting the view that ordinary people paying GKV contributions would have to pick up large additional costs, thanks to the law change. However, the reality is that price transparency remains the rule in Germany, and this is a very isolated exception. And there are unlikely to be many repeats.
This article is produced as part of聽, the world鈥檚 leading resource for global pharmaceutical pricing, HTA and market access intelligence integrated with the broader epidemiology, disease, clinical trials and manufacturing expertise of GlobalData鈥檚 色界吧 Intelligence Center. Our unparalleled team of in-house experts monitors P&R policy developments, outcomes and data analytics around the world every day to give our clients the edge by providing critical early warning signals and insights. For a demo or further information, please contact us聽.
