The German Merck subsidiary MSD has filed a constitutional complaint against central regulations of the Statutory Health Insurance Contribution Rate Stabilization Act because it sees itself as being heavily burdened by this.
The savings from the law are expected to cost MSD around one billion euros in 2028, which the company sees as disproportionate and damaging to its business.
MSD not only sees the law as violating its fundamental rights, but also fears negative consequences for innovation and jobs in Germany.
The head of Germany, Kevin Peters, emphasizes that MSD wants to stay in Germany despite the burdens and sees the lawsuit above all as a signal for fair regulation and political dialogue.
Munich. MSD, the German subsidiary of the US pharmaceutical company Merck, is going to the Federal Constitutional Court because of the federal government's austerity plans in the healthcare system. The company has filed a constitutional complaint in Karlsruhe against central provisions of the Statutory Health Insurance Contribution Rate Stabilization Act, said MSD Germany boss Kevin Peters in an interview with the Handelsblatt.
With the austerity package, the federal government wants to stabilize contributions to statutory health insurance (GKV). It provides for higher discounts for pharmaceutical companies, i.e. less money per drug, and stricter reimbursement rules.
This hits MSD particularly hard. The Merck Group, which operates under the name MSD outside North America, produces the cancer drug Keytruda, one of the world's top-selling drugs.
MSD Germany boss Peters said the reform passed in July endangers innovation and market access for new therapies in Germany. "Parts of this law are disproportionate. This is intolerable and massively harmful," said Peters. “I’ve never seen anything like it in 35 years of my career.” Peters sees the industry as an interface between research and the availability of medication for patients: “The bridge is crumbling and is in danger of breaking.”
According to calculations by the Association of Research-Based Drug Manufacturers (VFA), the savings will cost the pharmaceutical industry in Germany around 4.8 billion euros in 2028. “We would account for a fifth,” said Peters. That would be almost a billion euros. The company therefore has no other choice. “We want to make sure we leave no stone unturned.”
The fact that MSD is particularly affected is mainly due to the drug Keytruda, which is approved for the treatment of 16 tumor diseases and is considered a breakthrough in oncology. The company is under pressure. The US patent protection expires in 2028, after which cheaper copycat products usually come onto the market.
Treatment with the cancer drug costs the health insurance companies a lot of money. The National Association of Statutory Health Insurance Funds put the expenditure on Keytruda in 2025 at more than two billion euros.
The hurdles for success in Karlsruhe are high. In 2023, Roche and Abbvie filed a constitutional complaint against the then Statutory Health Insurance Financial Stabilization Act. In May 2025, Karlsruhe rejected the lawsuits, also with regard to the cumulative burden, i.e. the increasing burden due to various factors, which MSD is now relying on.
Peters is nevertheless optimistic: “We wouldn’t file the constitutional complaint if we weren’t convinced of it.” MSD submitted a 300-page brief in this regard.
MSD sees its fundamental rights as being directly violated. In the company's opinion, the extent, duration and cumulative effect of the measures exceed the constitutional limits of permissible cost containment.
“We are by no means submitting the lawsuit to the Constitutional Court lightly – but a limit has been reached here,” says Peters. In addition, MSD must protect 20,000 direct and indirect jobs in Germany. MSD has been present in Germany for 60 years and currently operates eight locations. According to its own information, the group contributes three billion euros to Germany's gross domestic product.
MSD has held discussions with the Chancellery, the Ministry of Health and the Ministry of Finance. With the complaint, the company is now sending a clear signal. Peters does not see this as a threat, but as an offer to cooperate. “The simpler alternative would be complete withdrawal – we reject that,” he says. “We don’t want to withdraw from Germany, we are rooted in Germany.”
It could be years before Karlsruhe makes a decision. But the situation is urgent, says Peters. He hopes that the step will bring more clarity, more weight for the issue on the political agenda and ultimately a concession from the federal government in the coming months.
The Ministry of Health wants to keep the contribution rates for statutory health insurance stable and save around 64 billion euros by 2030. At the same time, the federal government recently declared the pharmaceutical industry to be a leading industry with the aim of developing Germany into Europe's leading pharmaceutical location. This conflict of objectives between cost containment and industrial policy ambition is exacerbating tensions between the government and health insurance companies on the one hand and pharmaceutical companies on the other.
Corporations are increasingly appearing as political actors. In the summer, Boehringer Ingelheim and Eli Lilly announced that they would withdraw investments. Roche recently announced an investment freeze. The MSD case shows that the industry's influence has long gone beyond classic lobbying.
In principle, MSD says it supports the goal of stable statutory health insurance finances and sees itself as having a duty to make a contribution. However, Peters calls for fair regulation that does not place a disproportionate burden on innovation. Politicians concentrate too much on the manufacturer's discount. The overall effect of the individual measures of the law is more important. “I don’t think it’s clear to everyone involved how the cumulative burden is impacting a company like MSD.”
