You also have to remember that the German system (like many others) favors old, bad drugs over new, better drugs - for example, today you would never get a regulatory approval for Aspirin. Never. Ever. Oh, maybe you could sneak it through for anti-coagulation, but for pain?
But much better pain medications (e.g. Bextra) had to go, because the stesting is so much better. Aspirin probably has a kill ratio ten times as high, but who's to pay for comparative studies?
So the system favors the old products that have run out patents. Cheap at first glance, but that's not the whole story.
So why should we be surprised when other issues are amiss, too?