The German pharmacy landscape continues to experience significant changes as the number of operating pharmacies declines. At a recent assembly in Munich, the leadership of the Bavarian Pharmacists' Association (BAV) highlighted both progress and ongoing challenges brought on by recent legislative reforms.

Key Legislative Changes Affecting Pharmacies

The Pharmacy Supply Improvement Act (ApoVWG) and related regulations have introduced a series of updates aimed at strengthening the pharmacy profession. These include enhanced rules for prescription drug distribution, improved mechanisms to prevent reimbursement disputes, expansion of vaccination and testing services, new preventive care initiatives, and the limited dispensing of prescription medicines without a prescription in specific cases.

One of the most notable changes is that pharmacists, except for live vaccines, are now permitted to administer all vaccines to adults. This measure transforms vaccination from a seasonal to an all-year service, with the option to delegate the task to properly trained pharmaceutical staff. Negotiations on the details of compensation for these services are ongoing.

Additionally, pharmacies may now perform venous blood draws for diagnostic purposes in adults, allowing for the collection of more laboratory data, which can enhance the safety and decision-making of attending physicians.

Economic Adjustments and Remuneration

The BAV has welcomed the recent adjustment in fixed fees for prescription medications. As of July, the fee has been set at 9 euros, with a planned increase to 9.50 euros from January 2027. The fixed fee for compounded prescription medications remains at 8.35 euros. However, these positive steps are counterbalanced by rising operational costs, including increases in salaries and material expenses.

Concerns remain regarding the statutory discount pharmacies must provide to statutory health insurance funds when dispensing medications to insured patients. Under the Contribution Rate Stabilisation Act, this discount is scheduled to rise from 1.77 to 2.07 euros per prescription from January 2027, a change the BAV opposes in its current form, arguing it could negate the benefits of higher remuneration.

Reform of Emergency Services and Structural Issues

Emergency service compensation is set to nearly double from January 2027. The budget allocated for this increase is expected to suffice for approximately two years. In addition to the full emergency service flat-rate, partial emergency services will now also be eligible for subsidies, amounting to one-fifth of the full-service rate.

Despite these improvements, structural challenges persist. The new reforms allow for the representation of pharmacy technicians (PTAs) in strictly limited scenarios as part of a five-year pilot program. The establishment of branch pharmacies has also been made easier, though with minimal requirements, creating concerns about the stability of traditional pharmacy structures.

Future Tasks and Ongoing Reforms

Following the recent pharmacy law reforms, further legislative changes are on the horizon. Upcoming priorities for the sector include the implementation of the Contribution Rate Stabilisation Act, reforms to emergency medical services, new digital healthcare legislation, and adjustments to primary care structures. The BAV has expressed its commitment to actively addressing these challenges and supporting the continued viability of independent pharmacy practice in Germany.