How do you run AMNOG price negotiations and STIKO stakeholder processes in a structured way rather than case by case?
We prepare the negotiation with the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) using the Harvard Concept: interests instead of positions, a clarified best alternative to a negotiated agreement (BATNA), and objective criteria instead of haggling. In parallel, we support the STIKO stakeholder process for vaccine-related products. The difference from pure price negotiation: stakeholder management does not end with the reimbursement amount, it secures the relationship with payers, G-BA committees and prescribing professionals across the entire product lifecycle.
Overview
Why isn't a legally correct position alone enough in the negotiation?
Negotiation preparation using the Harvard Concept · AMNOG negotiation § 130b SGB V, arbitration procedure § 130b Abs. 4 SGB V, STIKO process § 20i SGB V
Last updated: August 5, 2026
The AMNOG reimbursement-amount negotiation and the STIKO stakeholder process are formally regulated, but their outcome also depends on how the negotiation itself is conducted. Four points determine whether a well-evidenced position actually becomes enforceable:
- The deadline is hard: under § 130b Abs. 4 SGB V, the manufacturer and the GKV-Spitzenverband have a maximum of six months after publication of the G-BA decision to reach agreement; after that, the arbitration board (Schiedsstelle) sets the reimbursement amount within three months, by free assessment of all circumstances of the individual case, not by the last figure either party named.
- Positions and interests are not the same thing: a negotiation that only haggles over a number often overlooks the other side's actual interest, for the GKV-Spitzenverband frequently budget predictability. The Harvard Concept (Fisher/Ury/Patton) deliberately separates the two and looks for options that serve several interests at once.
- For vaccines, it is not the GKV-Spitzenverband that decides on reimbursement, but the STIKO recommendation: the G-BA issues the Schutzimpfungs-Richtlinie under § 20i SGB V on that basis. Manufacturer stakeholder work has to start here, in the scientific hearing process ahead of the recommendation, not afterwards in a price negotiation.
- Negotiation and the ongoing payer relationship are two different tasks: the reimbursement-amount negotiation is a one-off, deadline-bound event; key account management with payers, G-BA committees and prescribing professionals continues across the entire product lifecycle.
Services
How we support you
Arbitration Procedure Support
Preparing for the arbitration procedure under § 130b Abs. 4 SGB V should the six-month deadline pass without agreement: building an argument that holds up before an arbitration board that weighs freely rather than renegotiating. The output is an arbitration-ready position paper.
STIKO Stakeholder Process
Supporting the scientific hearing process ahead of a STIKO recommendation for vaccine-related products, before it is implemented in the Schutzimpfungs-Richtlinie under § 20i SGB V. The output is structured evidence and stakeholder engagement before the recommendation, not after.
Key Account Management for Payers & Professional Stakeholders
Ongoing relationship management with payers, G-BA committees and prescribing professionals across the product lifecycle, kept distinct from the one-off price negotiation. The output is a documented stakeholder map with a contact cadence.
How we work together
What it comes down to
The reimbursement-amount negotiation under § 130b SGB V has a hard deadline: if no agreement is reached within six months of publication of the G-BA decision, the arbitration board sets the amount under § 130b Abs. 4 SGB V within three months, by freely weighing all circumstances of the individual case, not by the last figure named. Structuring the negotiation only shortly before the deadline loses exactly the preparation time that cannot be recovered in the arbitration procedure. We therefore prepare the negotiation using the Harvard Concept: positions and interests are separated, your own best alternative to a negotiated agreement (BATNA) is clarified, and the argument rests on objective criteria rather than a figure that is merely asserted.
For vaccine-related products, the path runs differently: it is not the GKV-Spitzenverband that decides on reimbursement, but the STIKO recommendation, on the basis of which the G-BA issues the Schutzimpfungs-Richtlinie under § 20i SGB V. Stakeholder work here has to start in the scientific hearing process ahead of the recommendation, not afterwards in a price negotiation. And regardless of the specific procedure: the one-off negotiation is not key account management. The relationship with payers, G-BA committees and prescribing professionals continues across the entire product lifecycle and feeds back into every subsequent assessment.
Our approach
Our approach
Step
Result
Stakeholder mapping
Documented overview of the relevant stakeholders (GKV-Spitzenverband, G-BA committees, the STIKO process, professional circles) and their respective interests.
Separate positions from interests
Worked-out interests behind your own and the counterparty's position, instead of a plain figure demand.
Clarify the BATNA
Documented best alternative to a negotiated agreement as a reference point for the negotiation.
Conduct the negotiation
Negotiation conducted against objective criteria, with a prepared escalation strategy for the arbitration procedure.
Continue the stakeholder relationship
Documented key account management that continues beyond the close of the negotiation.
Common pitfalls
Where projects commonly fail
The six-month deadline under § 130b Abs.
4 SGB V is underestimated. Developing a negotiation strategy only shortly before the deadline loses preparation time that cannot be recovered in the arbitration procedure: the arbitration board weighs the case freely afterwards, it does not keep negotiating.
Positions are confused with interests.
A negotiation fixated purely on a number fails to find options that serve several interests at once: that is exactly the core of the Harvard Concept, and exactly what gets skipped most often under time pressure.
STIKO stakeholder work is treated like an AMNOG price negotiation.
For vaccines there is no reimbursement-amount negotiation with the GKV-Spitzenverband: the STIKO recommendation and the resulting Schutzimpfungs-Richtlinie under § 20i SGB V decide the matter differently and earlier in the process.
Negotiation and the ongoing payer relationship get mixed up.
Treating the one-off reimbursement-amount negotiation as equivalent to permanent key account management loses contact, after the contract is signed, with exactly the stakeholders who become relevant again for follow-on decisions.
Market Access, RWE & Reimbursement
Do any of these pitfalls apply to you?
In a first call we assess your situation and say what needs clarifying first in your case. Without obligation, reply usually within one working day.
FAQ
Frequently asked questions
Sources
- Fünftes Buch Sozialgesetzbuch (SGB V), German Social Code, Book V - primary text, § 130b, § 20i
- Schutzimpfungs-Richtlinie (SI-RL) of the Federal Joint Committee - primary text
- Fisher, R. / Ury, W. / Patton, B.: Getting to Yes - Negotiating Agreement Without Giving In (Harvard Negotiation Project), published in German as 'Das Harvard-Konzept'
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Case Studies
What this looks like in practice
Latest insights
All insights →Regulations & standards considered
- § 130b SGB V (agreement on the reimbursement amount between the GKV-Spitzenverband and the pharmaceutical manufacturer)
- § 130b Abs. 4 SGB V (arbitration procedure if no agreement is reached)
- § 20i SGB V (services for the prevention of communicable diseases, the basis for the Schutzimpfungs-Richtlinie)
- Schutzimpfungs-Richtlinie (SI-RL), the Federal Joint Committee's (G-BA) vaccination directive
Related topics
Pricing & Reimbursement →
The substantive basis of the AMNOG reimbursement-amount negotiation
Tender & Negotiation →
Negotiation within a procurement procedure rather than the AMNOG reimbursement-amount negotiation
Market Access Strategy →
The strategic framework in which negotiation and stakeholder management sit
Have a concrete project?
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