Internet pharmacies were supposed to offer a double benefit: not only would patients save money with access to cheaper medications; Germany's overburdened public health system -- estimated to be between €6 and €14 billion ($7.3 and $16.9 billion) in debt -- would save too.

But according to an investigation carried out by KVB, an association representing doctors who have patients with public insurance, online prescriptions are just as expensive as traditional ones picked up in the corner bricks-and-mortar pharmacy.

"The results were clear: (Internet) merchants are orienting themselves to the penny to already existing price guidelines for medications," Dr. Leonhard Hansen, a deputy director at KVB, told reporters at a news conference on Monday. Those guidelines are used by traditional pharmacies to set their prices.

Patients save by buying online, according to KVB, only when it comes to over-the-counter medications. "Then the savings are from ten to 30 percent," said Hansen.

The government had hoped that opening up the market for medications would create a competitive environment that would bring the cost of prescription drugs down. "A price war that we had hoped for following the health reforms has failed to appear," said Hansen.

Fewer doctor's visits

But another of the controversial health care reforms that went into effect this year seems to be having the intended effect, according to KVB. Starting January 1, patients are required to pay a €10 fee per quarter for doctor's office visits. In the first quarter of the year, studies have shown that 10 percent fewer people went to the doctor. The trend has continued into the second quarter, according to a surveys of various doctors' practices around the country.

"People aren't going to the doctor for just any little trifle anymore," Klaus Vater, a spokesman for the health ministry, told reporters.

Despite the fall in trips to the doctor, Hansen said he did not see any of the "horror scenarios" critics of the reforms had painted in the lead-up to the changes.

"We haven't noticed any cuts in the level of basic care," he said. He warned, however, that because of the new fees, poor people were seeking a doctor's help less than they should, thereby putting off treatment and potentially suffering more serious health problems over the long term. Such developments, he said, would have to be watched over the long run.

Meeting savings goals?

Although the health ministry has pointed to successes, the hoped-for overall savings will likely not materialize, according to KVB. When the reforms were passed, Health Minister Ulla Schmidt estimated savings of up to €3 billion on medications alone in 2004. But Hansen said a more realistic forecast would be somewhere in the neighborhood of €1.4 billion and €1.8 billion for this year.

The health ministry has rejected the lower estimate and is sticking by its forecast.