The German Federal Union of Associations of Pharmacists (ABDA) has put forward a series of recommendations aimed at stabilizing the finances of the statutory health insurance system (GKV), as part of a broader government initiative to address rising deficits in the sector. The proposals were submitted to the recently established Health Finance Commission, which is tasked with developing actionable strategies to ensure the long-term sustainability of GKV funding.

Faced with continuously increasing contribution rates and growing financial pressures, the Health Finance Commission--comprised of ten experts from economics, medicine, social law, ethics, and prevention--has sought input from key stakeholders across the healthcare system. Through a structured online questionnaire, participants were invited to identify potential cost-saving measures both within their own domains and in the broader healthcare landscape.

ABDA's response emphasizes the significant role pharmacies can play in boosting efficiency and cost-effectiveness within the German healthcare system. Central to their recommendations is the expansion of pharmacy-led healthcare services, particularly in areas of prevention and primary care.

Enhancing Preventive and Pharmacy-Based Care

ABDA identifies substantial savings potential through greater integration of pharmacies into preventive healthcare and the provision of more direct, pharmacy-based services. By advocating for a "pharmacy first" approach, the organization suggests that patients could initially seek guidance and care from pharmacists for certain conditions, reducing unnecessary visits to general practitioners and streamlining patient pathways.

This model would enable pharmacists to manage a range of clearly defined medical issues--such as minor infections or uncomplicated illnesses--under established protocols and within the boundaries of current pharmaceutical legislation. According to ABDA, this approach could save both time and resources, while also enhancing the public's trust in the efficiency of the healthcare system.

Regulatory Framework for Expanded Pharmacy Services

Current regulations, including sections 48a and 48b of the German Medicines Act (AMG), already permit pharmacists to dispense prescription medicines for follow-up treatments and, under certain conditions, provide prescription medications for specific indications. ABDA recommends building on these provisions by developing clear clinical criteria and evidence-based guidelines for pharmacy-led care in areas such as uncomplicated urinary tract infections or conjunctivitis.

Pharmacies would deliver these services following comprehensive pharmaceutical counseling and upon confirmation of established prerequisites, such as positive rapid test results or ongoing maintenance therapy. This would not only improve access to care but also minimize unnecessary duplication of consultations and enhance the overall efficiency of the healthcare system.

Wider Implications for Health System Efficiency

ABDA's proposals also underscore the economic relevance of reducing redundant healthcare interactions, highlighting the potential for pharmacies to contribute to broader cost-containment efforts. By shifting certain aspects of care to the pharmacy sector, the health system could experience both direct savings--through reduced physician workload--and indirect benefits, such as improved patient satisfaction and streamlined care delivery.

These recommendations form part of a broader package of suggestions collected from various health sector stakeholders, as the Health Finance Commission works towards a comprehensive reform plan. The commission is expected to present its initial findings by March 2026, with the goal of implementing durable solutions to stabilize insurance contributions from 2027 onward.

As discussions continue, the role of pharmacies in Germany's healthcare landscape is likely to remain a key topic in the ongoing search for effective and sustainable financial reforms within the statutory health insurance system.