After a long wait, the draft bill for the Healthy Heart Act was finally published by the Federal Ministry of Health on 19 June 2024.
It contains a mix of primary and secondary prevention measures to strengthen heart health. From the SHD Coalition’s perspective, four measures are particularly pleasing:
- Firstly, the heart check-ups 25, 35 and 50 already announced in the impulse paper have been retained, with an explicit focus on early detection measures at check-ups 50. The health insurance companies must pay for them and invite their policyholders to attend them.
- Secondly, in addition to the check-up examinations, supplementary laboratory tests are also prescribed; it has not yet been defined which tests are included, but it would also be possible to determine the NT-pro BNP level, which can indicate possible heart valve disease.
- Thirdly, the medical (cardiac) associations play an important role in the design of individual measures. This is very welcome, as it will allow cardiological experts to include early detection measures where possible
- Fourthly, the draft law stipulates that the disease management programmes for chronic heart failure and coronary heart disease will be strengthened and expanded. Health insurance companies must now offer their policyholders a DMP if they have been diagnosed with the disease, leading to improved care for those affected.
In this respect, the draft bill already contains great approaches. Although the group of over 65-year-olds has not yet been mentioned. This absolutely must be changed. As it is well known that older people aged 65 and over are particularly affected by structural heart disease and that check-ups are therefore of particular importance. The SHD Coalition is committed to this in collaboration with other cardiological stakeholders.
The representatives of the Federal Joint Committee (G-BA) and the health insurance funds as well as doctors associations consider the draft law to be completely misguided in most respects. At the hearing of associations organised by the BMG, it became clear that the preventive examinations and screenings specified by the legislator in a statutory order and the allocation of drugs, especially statins, were met with massive criticism, as they would represent a considerable encroachment on the area of responsibility of self-administration. It is also criticised that the G-BA and its experts cannot carry out an evidence-based method assessment for these therapies as is usually the case. Overall, many of the stakeholders mentioned see the draft law as a missed opportunity to put primary prevention on a broader footing and criticise the strong focus on early detection. This focus has also come about thanks to the great work of the SHD Coalition.
The draft law is currently still in the departmental coordination phase and is expected to be approved by the cabinet at the end of August, before being presented in the first reading in the Bundestag in October.
If everything goes as planned, and Health Minister Prof Lauterbach is very determined, the draft could come into force at the beginning of next year (i.e. before the end of the legislative period).
In conclusion, it can be said that although the draft law still need a bit of revision, it is a big step in the right direction and will significantly improve heart health in general and the early detection of structural heart disease in particular.