Germany offers all citizens access to high-quality healthcare through its modern and internationally competitive healthcare system. Other fundamental principles of statutory health insurance in Germany, such as solidarity and the benefits-in-kind principle, are considered a model worldwide. Furthermore, the innovative healthcare system is economically relevant for the location of Germany. High-level patient care is financed by contributions amounting to around 140 billion euros annually for the statutory health insurance (GKV). However, developments in the pharmaceutical market indicate management issues, as expenditures for medications have been rising for years at the expense of the GKV, while prescription numbers have been declining. The German pharmaceutical market is characterized by dirigiste price regulation and, since the Health System Modernization Act (GMG), by conditional price negotiations that have been expanded with the Competition Strengthening Act for Statutory Health Insurance (GKV-WSG). A stronger competition orientation intended by the legislator allows for selective contracting between statutory health insurance funds and pharmaceutical companies. This enables the establishment of discount agreements for medications between the mentioned parties, resulting in savings for the health insurance funds and new market shares for pharmaceutical manufacturers. This study addresses the discount agreements for medications according to Section 130a (8) of the Social Code Book V and their impact on the stakeholders in the German healthcare system. A critical analysis highlights the consequences of this modified instrumentarium since the GKV-WSG for patients, service providers, and statutory health insurance.