Pharmacy Reform Faces Criticism Over Impact on Local Healthcare
The ongoing debate over pharmacy reform in Germany has intensified as key stakeholders raise concerns regarding proposed legislative changes. The German Federal Union of Associations of Pharmacists (ABDA) and other invited organizations are currently preparing formal feedback on the draft legislation, with discussions already underway at the state level involving ministries, parliamentarians, and high-ranking coalition representatives.
The ABDA has conducted a thorough assessment of the draft bills, identifying several critical focus areas. Among the foremost issues is the absence of an adjustment to the fixed remuneration (Fixum) for pharmacies, which has not been increased as initially outlined in the coalition agreement. Another point of contention is the perceived inadequacy of guidelines for negotiating pharmacy fees, as well as the controversial proposal to allow pharmacy technical assistants (PTAs) to act as substitutes for pharmacists under certain circumstances.
According to the ABDA, the draft proposals for the Pharmacy Supply Advancement Act and related amendments to the drug pricing and pharmacy operating regulations do not fulfill their intended goals. The organization argues that rather than strengthening the pharmacy sector and safeguarding comprehensive, local access to medication, several measures could potentially weaken the existing system. The ABDA emphasizes that minor improvements for patients cannot compensate for the negative effects these measures may have on overall healthcare delivery.
One of the central concerns is the delay in increasing the fixed fee for pharmacy services from EUR8.35 to EUR9.50, a change that was originally promised in the coalition agreement. Federal Health Minister Nina Warken (CDU) has postponed this adjustment to the following year, citing the need for further review. The ABDA warns that without this increase, the trend of pharmacy closures is likely to continue, posing a risk to the accessibility of local pharmaceutical services. The organization also questions why regular adjustments for other service providers within the pharmacy sector have not been implemented for several years.
The draft legislation proposes that the German Pharmacists' Association and the National Association of Statutory Health Insurance Funds engage in direct negotiations over pharmacy remuneration. While the ABDA supports the principle of negotiated agreements, it contends that this approach cannot replace the necessary increase to the fixed fee. Additionally, the organization believes that measures such as discount approvals or regional compensation are insufficient to ensure the sustainability of community pharmacies.
Further, the ABDA calls for more precise regulations and greater reliability in the implementation of negotiated solutions regarding pharmacy remuneration. The association maintains that the current proposals lack the clarity required to guarantee effective and consistent application, which is vital for the stability of the sector.
Debate continues around the proposal to permit PTAs to temporarily stand in for pharmacists, which many in the profession view as a departure from established practice. Critics argue that this change could compromise the quality of pharmaceutical care and undermine the professional autonomy of pharmacists.
As the deadline for official feedback approaches, the pharmacy sector remains engaged in active discussions with political stakeholders. The outcome of these consultations is expected to play a significant role in shaping the final version of the pharmacy reform legislation and the future of pharmacy services in Germany.