Germany is widening screening where the evidence is settled and reopening it where cost is the question. The mammography extension follows a 2021 EU guideline update and a radiation-protection ordinance that took effect in March 2026. Skin screening and the check-up arrive at review with a savings proposal already attached, which changes what the G-BA is being asked to prove.

• Diagnostics and imaging suppliers: screening volume moves in both directions from 2027. The mammography extension adds screening demand from August 2027. The check-up review weighs a urine dipstick test, a one-time HIV test and a risk-adapted check-up, each a new test volume if adopted, while a risk-based skin programme would cut routine examinations.
• Oncology sponsors facing AMNOG: a choice-of-regimen comparator arm can work. IQWiG accepted BREAKWATER’s comparator arm, which let investigators choose among standard chemotherapy regimens, as representing the G-BA’s individualised comparator, while noting that no selection criteria were pre-specified. With EU joint clinical assessments also asking for several comparators at once, that design is worth copying.
• Signposts: January, the ministry and the skin review. Statements on Braftovi close on 5 November and the G-BA decision is expected in early January 2027. Watch the ministry’s review of the mammography decision, and whether the skin review ends in a narrower risk-based programme before its end-2027 deadline.