Insights  /  Regulatory · Authorisation
Into Germany · the approval itself

Getting a medicine authorised for Germany: four routes, one choice

For some products the route is decided for you by EU law. For the rest it is a strategic choice with real commercial consequences — how many markets you open at once, how long it takes, and which German authority reads your dossier. Choosing badly is not fatal, but it is slow, and slow is expensive.

10 min read Reviewed by Ralf Müller, Regulatory Affairs Lead Updated 2026
In one paragraph

There are four ways to get a medicine authorised for the German market. The centralised procedure (EMA) is mandatory for biotechnology-derived products, biosimilars, ATMPs, orphan medicines and new active substances in areas such as cancer, HIV/AIDS, diabetes and neurodegenerative disease — and gives one authorisation valid across the EU. Otherwise you choose: decentralised (several member states at once, nothing authorised yet), mutual recognition (already authorised somewhere, extend it) or purely national (Germany only). In Germany the assessing authority is BfArM for most products and the Paul-Ehrlich-Institut for vaccines, sera, allergens, blood products and advanced therapies. The authorisation lets you sell. AMNOG decides what you are paid.

The step everyone skips over

Companies arrive with a plan for the trial and a plan for the price. The authorisation route in between is often treated as paperwork — and it is the decision that sets the calendar for both.

The route determines how many markets you can enter simultaneously, which regulator's questions you answer, whether one national objection can hold up the whole procedure, and when your German launch clock — and with it the benefit assessment — actually starts. It is a commercial decision dressed as a regulatory one.

First establish whether you have a choice at all. For a large share of modern medicines, EU law has already made it.

The decision

Two questions decide your route

Work through them in order. The first one often ends the discussion.

Is your product within the mandatory scope of the centralised procedure?Question 1
Yes

Centralised procedure

One application to the EMA, one Commission decision, one authorisation valid in every EU member state. No choice to make — and no need to repeat the exercise country by country.

No — you choose

Question 2: how many markets, and when?

The centralised route may still be open to you optionally. Otherwise the answer depends on whether the product is already authorised somewhere in the EEA.

Decentralised (DCP)Not yet authorised anywhere. Several member states assess in parallel, led by a reference member state.
Mutual recognition (MRP)Already authorised in one member state. Others recognise that authorisation and extend it.
NationalGermany only. BfArM or PEI assesses; no other market is opened.

The mandatory centralised scope

If your product falls in here, the centralised procedure is not an option you weigh — it is the only route.

Under the EU pharmaceutical regulation, the centralised procedure is mandatory for:

  • Biotechnology-derived medicines — recombinant DNA technology, controlled gene expression, hybridoma and monoclonal antibody methods.
  • Biosimilars — similar biological medicinal products.
  • Advanced therapy medicinal products (ATMPs) — gene therapy, somatic cell therapy and tissue-engineered products.
  • Orphan medicinal products.
  • New active substances for AIDS, cancer, neurodegenerative disorders, diabetes, auto-immune diseases and other immune dysfunctions, and viral diseases.

There is also an optional centralised route: products representing a significant therapeutic, scientific or technical innovation, or where an EU-level authorisation is in the interest of public health. Worth considering even when not compulsory — a single procedure that opens the whole EEA can beat four national ones.

The four routes compared

What each route is for, and what you actually end up holding.

RouteUse whenWhat you getGerman role
Centralised
CP · EMA
Product is in the mandatory scope, or you opt in for innovation / public-health grounds. One authorisation valid across the EU and EEA. BfArM or PEI experts participate in the EU assessment; the decision is European.
Decentralised
DCP
Not yet authorised anywhere in the EEA and you want several markets at once. Parallel national authorisations in the chosen member states. Germany can act as reference member state or as a concerned member state.
Mutual recognition
MRP
Already authorised in one member state; you want to extend to others. The existing authorisation recognised and mirrored in further member states. Germany recognises another state's authorisation, or is the one recognised.
National
Germany only
Germany is the only market you need, now or for the foreseeable future. A German authorisation only. BfArM or PEI assesses and grants directly.

On timing: in the decentralised route the reference member state's evaluation can run up to 210 days, and by day 210 at the latest the concerned member states are to agree the final assessment report — unless one considers that authorisation would pose a serious risk to public health. That last clause is the reason multi-country routes carry a tail risk a national one does not.

More markets in one procedure also means more places a single objection can stop it.

BfArM or PEI — who reads your dossier

Germany splits competence by product type, and the split follows the product through its whole life: trials, authorisation and ongoing safety obligations.

BfArM

Federal Institute for Drugs and Medical Devices

Competent for granting marketing authorisations for most medicinal products, and runs national, decentralised, mutual-recognition and centralised-procedure work on the German side.

Paul-Ehrlich-Institut

PEI

Competent for vaccines, sera, allergens, blood and blood products, and advanced therapy medicinal products.

The same authority you meet at the clinical-trial stage is generally the one you meet again at authorisation — see clinical trials in Germany, where the identical split applies.

A structural requirement

The authorisation holder must be established in the EEA

A marketing authorisation cannot be held by a company established outside the European Economic Area. A manufacturer in the US, Japan, Korea or India therefore needs an EEA-established entity — its own subsidiary, or a partner — to be the marketing authorisation holder, and that holder carries the continuing obligations that come with it: pharmacovigilance, batch release oversight, variations, renewals and communication with the authorities.

This is the same structural question that appears at every stage of a regulated entry, under different names: the sponsor's legal representative for trials, the authorised representative for devices, the authorisation holder for medicines. Whoever holds it holds your access — a point we make in local representation, and one worth deciding deliberately rather than by default.

What authorisation does not give you

A marketing authorisation is permission to place the product on the market. In Germany that is the beginning of the commercial process, not the end of the regulatory one.

It does not set a price, does not oblige any payer to reimburse, and does not put your product in a hospital or a pharmacy. For a new medicine, the German launch triggers the benefit assessment and the price negotiation that follow — and those decide your actual revenue. Ongoing obligations start at the same moment: pharmacovigilance, a named responsible person, variations and renewals.

Which is why the authorisation route should be chosen with the payer timeline in view, not only the regulator's. An EU-wide authorisation obtained quickly is only an advantage if the evidence behind it will also survive the AMNOG benefit assessment.

Authorised means allowed to sell. It has never meant paid.

How we help

Pick the route that fits the business, not just the file

We help international manufacturers choose between the centralised, decentralised, mutual-recognition and national routes, work out which German authority they will face, settle the authorisation-holder question, and line the whole thing up against the reimbursement clock that follows.

RM
Reviewed by Ralf Müller
Regulatory Affairs Lead · authorisation & compliance