Oct. 16 (Bloomberg) -- Patients may need two doctors to sign off on prescriptions before their public health insurance will cover four expensive medicines for a potentially fatal lung condition.

The Federal Joint Committee called for a second doctor's review on prescriptions for Actelion Ltd.'s Tracleer and Ventavis and Pfizer Inc.'s Revatio and Thelin today in a statement released prior to a press conference in Berlin. The drugs treat pulmonary arterial hypertension. The committee regulates coverage for Germany's more than 70 million public insurance patients.

``We assume that this policy to require second opinions will serve the cause of a better standard of care, because it requires doctors to think carefully before prescribing certain medications,'' committee Chairman Rainer Hess said at the press conference. ``It's also about cost-effectiveness.''

The new rule, which will go the Health Ministry for approval, is part of an effort by Germany to rein in health-care expenses as the costs of new treatments rise and the population ages. Pharmaceutical companies and physicians opposed the ruling, saying it adds a lengthy and unnecessary layer of bureaucracy for patients and their doctors.

``It's an effort to save money,'' said Hans-Joerg Freese, spokesman for the German Medical Association, which represents almost 414,000 doctors in the country. ``But that shouldn't be done at the expense of patients.''

3,000 Patients

Pulmonary hypertension causes arteries to narrow and can lead to heart failure. PAH affects 3,000 patients in Germany at an annual per-patient cost of 11,000 euros ($15,000) for Revatio to 110,000 euros for Ventavis, the committee said.

Germany's public insurers spent 26.5 billion euros at pharmacies last year, said Wolfgang Strassmeir, spokesman of the German Pharmaceutical Industry Association, which opposed the ruling.

AstraZeneca Plc's Chief Executive Officer David Brennan has said the global credit crisis could put pressure on publicly funded medical coverage because the governments providing rescue packages ``are also the ones paying for health care.''

The German joint committee next will consider requiring a second opinion on drugs for colon cancer, Hess said today. The regulation on PAH drugs is expected to go into effect on Jan. 1. Requiring a second opinion on expensive and high-risk drugs was part of the German health-care overhaul passed in 2007.

Committee members who represent doctors and insurers said they want to wait two years to evaluate the new rule before implementing it beyond PAH and colon cancer.

``It's a bit like reading the tea leaves,'' said Axel Meessen, who represents public insurers on the committee, adding that it's unclear how much money the new regulation will save.

To contact the reporter on this story: Naomi Kresge in Berlin nkresge@bloomberg.net

Last Updated: October 16, 2008 09:56 EDT