Medical Community Raises Concerns Over Planned Pharmacy Reform

The introduction of the Pharmacy Supply Enhancement Act (ApoVWG) by the German government has sparked significant concern among leading representatives of the medical community. The legislation, currently under review, proposes to expand the responsibilities of pharmacies, allowing them to dispense prescription medications under certain strictly defined conditions. Additionally, the proposed reform would enable pharmacies to offer a wider range of services, including immunizations and diagnostic testing for various illnesses.

According to the draft bill, the Federal Ministry of Health intends to collaborate with the Federal Institute for Drugs and Medical Devices, as well as the respective pharmaceutical and medical associations, to determine which prescription medications may be dispensed without a prior medical prescription. However, medications with a high potential for misuse or dependency and systemically acting antibiotics are expressly excluded from this provision.

The National Association of Statutory Health Insurance Physicians (KBV) has expressed reservations regarding the transfer of traditional medical responsibilities to pharmacists. KBV officials emphasized that medical diagnostics, determination of indications, and therapeutic decisions constitute core medical functions and should remain within the domain of trained physicians. They further underscored that while pharmacists possess specialized expertise within their field, they do not have the same qualifications as medical doctors to conduct comprehensive patient assessments or initiate complex therapies.

One of the major points of contention involves the planned expansion of testing capabilities within pharmacies. The reform envisions pharmacies conducting tests for a variety of infectious agents, including adenoviruses, influenza, noroviruses, respiratory syncytial virus (RSV), and rotaviruses. Furthermore, pharmacies would be authorized to conduct preventive health screenings, such as blood pressure and blood glucose measurements, to help identify risk factors for cardiovascular diseases, diabetes, and obesity at an early stage.

Medical professionals are concerned that broadening the scope of pharmacy-based services may lead to an increase in non-evidence-based or unnecessary testing performed by individuals without full medical training. This development, they argue, could result in a higher frequency of follow-up consultations and diagnostic work within physicians' practices, potentially increasing the overall burden on the healthcare system. Additionally, they warn that patient safety could be compromised if medical decisions are made without the comprehensive evaluation typically provided by a physician.

Despite the stated objective of the reform to strengthen local pharmacies and alleviate pressure on outpatient medical care, medical associations maintain that these changes could erode established medical competencies and fragment the current healthcare structure. The debate surrounding the ApoVWG highlights the need for clear boundaries between the distinct roles of pharmacists and physicians, ensuring that patient safety and the quality of care remain paramount.

The Federal Ministry of Health has indicated that it will seek input from relevant professional bodies before finalizing the list of medications eligible for pharmacy-based dispensing. The outcome of these consultations, as well as the broader implications of the proposed reform, remain subjects of ongoing discussion among stakeholders within Germany's healthcare sector.