The French and German reimbursement systems use the same definition of pharmaceutical innovation: additional medical benefit versus a comparator. But differences in each approach mean the outcomes will not always be the same.

According to reimbursement consultants contacted by BioCentury, Germany's AMNOG system is more quantitative and uses a narrower definition that is less accepting of surrogate markers for patient benefit, while the French system is more pragmatic in its determinations of additional benefit.