Planned PTA Substitution Unlikely to Alleviate Pharmacy Struggles
The proposed legislative change by the Federal Ministry of Health to allow pharmaceutical technical assistants (PTAs) to temporarily manage pharmacies is facing criticism for its limited impact on the current challenges faced by community pharmacies in Germany. The draft amendment, part of the Pharmacy Care Advancement Act (ApoVWG), recommends that pharmacy owners can be represented by specially trained PTAs for up to 20 days per year, with a maximum of ten consecutive days. The intention behind the proposal is to help sustain pharmacy operations, especially in rural areas, and address staff shortages.
However, recent industry analyses suggest that this measure is unlikely to provide significant relief for small or struggling pharmacies. According to recent data, most pharmacies now employ more licensed pharmacists per location than in the past. This trend is largely attributed to the ongoing reduction in the overall number of pharmacies, which has resulted in larger average pharmacy sizes and higher staffing levels.
In 2005, approximately 46,276 licensed pharmacists worked across 21,441 public pharmacies, averaging just over two pharmacists per location. Over the years, as the number of operating pharmacies declined, the average number of pharmacists per pharmacy increased. By last year, 53,235 pharmacists were distributed among 17,041 pharmacies, averaging over three pharmacists at each site. This development means that most pharmacy owners already have sufficient qualified staff to cover absences due to vacation or illness, reducing the necessity for additional substitution options like the proposed PTA stand-ins.
Industry organizations and associations have consistently raised concerns about eroding the legal requirement for a licensed pharmacist's presence in retail pharmacies. They argue that replacing a pharmacist with a PTA, even temporarily, could undermine the integrity of pharmacy operations and compromise patient safety. These associations believe that the current framework, which mandates pharmacist oversight, is essential for maintaining high standards in pharmaceutical care and for safeguarding public health.
The Federal Ministry of Health, on the other hand, maintains that introducing temporary PTA representation could make the PTA profession more attractive, help alleviate personnel shortages, and reduce costs for pharmacy owners who would otherwise need to hire external, fully licensed substitutes. Nevertheless, experts point out that the number of pharmacies continues to decline, and the measure is unlikely to reverse this trend or resolve the systemic issues facing the sector.
Furthermore, the proposed amendment does not address the underlying economic and regulatory challenges threatening the viability of small, independent pharmacies, particularly in rural and underserved areas. Many pharmacy owners are seeking more comprehensive reforms, including financial support and regulatory adjustments, rather than temporary staffing solutions.
The current debate highlights the complexity of pharmacy sector reform in Germany. While the intention behind the new legislation is to ensure continued access to pharmaceutical services, especially in less populated regions, critics argue that the proposed PTA substitution is not an effective remedy for the broader issues at play. The ongoing reduction in pharmacy numbers, increasing operational pressures, and continued calls for regulatory improvements suggest that further policy measures may be necessary to secure the future of community pharmacy care.