German hospital procurement is committee-driven, slow and rule-bound. A reimbursement code doesn't get your product used — a hospital still has to choose it, through a process where clinicians, pharmacy, procurement and controlling all have a say. Winning it is a campaign, not a pitch.
Germany has around 1,900 hospitals — public, non-profit and private chains — and buying is rarely a single decision. Access runs through three routes: tenders (public hospitals follow EU / German procurement law), group purchasing organisations (Einkaufsgemeinschaften) that aggregate demand across many hospitals, and direct or distributor relationships. In every case a committee decides — clinical champions, pharmacy, procurement and controlling — and the second meeting is earned by evidence, reliability and a credible local presence, not a cold pitch.
A CE mark lets you sell and a reimbursement code lets you be paid — but neither makes a hospital use your product. That decision is made inside the hospital, by several people, over months.
For a foreign manufacturer used to a champion-led sale, the German hospital is a shock: no single buyer, a formal process, budget pressure, and value-analysis committees that weigh clinical benefit against cost. Access is won by understanding who sits at the table and giving each of them what they need — and by being reliably present long enough to be evaluated at all.
In a German hospital, nobody buys alone — so nobody is sold alone.
A new product usually needs several people to say yes. Win the clinician but lose controlling and you don't get in. Each seat weighs something different.
Wants the clinical benefit and the evidence. Necessary — but not sufficient on their own.
Controls the formulary and supply; weighs safety, handling and stock.
Runs the process, tenders and contracts; wants terms, reliability and price.
Weighs the total cost against the DRG or NUB payment — where a premium product is won or lost.
Assesses integration, hygiene, training and technical fit with existing systems.
Many hospitals run a formal committee that scores new products on benefit vs cost before adoption.
Map the table before the first meeting. Knowing who weighs what — and arming your champion to answer procurement and controlling — is the difference between a pilot and a polite no.
Product reaches a German hospital through one of three channels — and most manufacturers use more than one.
Public hospitals must tender above certain values under EU / German procurement law — a formal, criteria-driven process you qualify for and bid into.
Purchasing organisations aggregate demand across many hospitals and negotiate framework agreements — win one and you reach dozens of hospitals.
Direct key-account relationships or specialist distributors — often the route for premium, technical or clinician-driven products.
Around 1,900 hospitals fall into three ownership types, and increasingly into large groups that centralise purchasing.
The trend is consolidation: as chains and purchasing groups grow, buying decisions move up from the single hospital to the group — which changes who you need to convince.
Public hospitals are contracting authorities, so above EU thresholds their purchases follow public-procurement law: the GWB and the procurement ordinance (VgV), with lower-value contracts under the UVgO.
German hospitals commit gradually. Trust, reliability and evidence decide who gets past the first conversation.
Adoption typically starts small — a pilot or a single department — and broadens as the product proves itself. What earns that first step:
A credible presence on the ground is often the precondition for being evaluated at all — the second meeting is earned by trust and evidence, not a cold pitch from abroad.
Even with reimbursement secured, the hospital still has to choose to buy and use your product — and if it's bundled into a DRG, the budget pressure works against a premium item. Reimbursement and hospital access are two linked but separate battles: one gets you paid if used, the other gets you used.
Getting the code is the reimbursement fight. Getting bought is the hospital fight. You need both. See medical device reimbursement.
In a focused session we identify the right access route (tender, purchasing group or direct), the decision-makers to convince, and the evidence and local setup that earn the second meeting — and we approach the accounts worth starting with.