The number of pharmacies in Germany has been declining for years, with local dispensaries burdened by a growing lack of skilled workers, increasing costs and a fair amount of bureaucratic constraints.
In an effort to secure reliable access to medications across the country, Health Minister Nina Warken is pushing a pharmacy reform aimed at easing some of these pressures, as well as broadening the scope of services pharmacies may offer.
The draft law for the reform was passed by the Bundestag on Friday. Here's what it means for patients in Germany.
In addition to providing prescription and over-the-counter medicines, Warken's reform will allow pharmacies to offer more services for patients, including vaccinations and some preventative care.
For many people, pharmacies are already the first points of contact when it comes to health issues, Warken said. Therefore it's logical to make certain services more accessible there.
Other goals of the reform are to give pharmacy operators more responsibility and flexibility, with a focus on addressing the pressures and constraints experienced by pharmacies in rural regions that face staff shortages and declining profitability.
Preventative medicine
Under the reform, pharmacies will be able to offer certain services for prevention and early detection -- for example for cardiovascular diseases, diabetes and smoking.
Vaccinations
Patients can already receive a flu shot at some pharmacies, and since 2022 patients can also get COVID-19 vaccines here.
Going forward pharmacies will also be able to administer all "inactivated" vaccinations. These include vaccines against tetanus or tick-borne encephalitis (TBE), for example.
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Rapid tests
As with covid tests during the pandemic, patients should be able to get self-paid rapid tests for certain illnesses -- like influenza, noroviruses or rotaviruses.
Streamlined access to medication
In certain cases, the reform allows pharmacies to dispense prescription drugs without seeing a doctor's prescription.
This would be possible with certain medications that patients are required to take for pro-longed periods. A one-time dispersal of medicine would be allowed to prevent the disruption of the continuation of therapy.
In these cases, patients would have to pay for the drugs themselves.
The draft also says medicines could be provided without prescription in the case of "uncomplicated forms of certain acute diseases". But the ministry is reportedly still considering which specific requirements would apply.
However, "systemic antibiotics" and drugs with a high potential for abuse or dependence would be strictly excluded.
Substitution
When a specific medication is not in stock, the reform should make it easier to get alternatives. Pharmacies will be allowed to dispense a similar product that they have immediately available.
The idea being that patients would thus receive faster care, and pharmacies would be relieved of the burden of ordering. This measure is initially planned to be tested for a limited period.
Blood sampling
Pharmacies will also be able to take standard blood samples, for example to control the effects of medication.
This will only be allowed for patients aged 18 and over, and only when staff have the necessary medical training to do so.
Opening hours
Patients could see opening hours at their local shop change, as pharmacies are to be given more responsibility to set their own opening hours.
In this way, business hours could be better adapted to demand, the ministry explained.
Drug prices
The federal coalition added a regulation on drug prices to the reform which limits health insurance companies from negotiating discounted price contracts on drugs with expired patent protection until mid-2028.
Lawmakers say this is intended to secure supply and encourage biotechnological development in Germany. But the health insurance companies criticised it as a "gift" to the pharmaceutical industry.
Pharmacies demand higher fees
The reform says that going forward the German Pharmacists' Association is to negotiate together with the National Association of Health Insurance Funds on remuneration.
Pharmacists have been calling for an immediate increase to the fee, funded by statutory health insurance funds, that pharmacies collect on orders filled.
Pharmacies currently receive a fixed fee of €8.35 per prescription - a rate that has not increased since 2013.
Health Minister Warken suggests she wants to implement a fee increase by decree in two stages: Initially to €9, and then to €9.50 euro in 2027.
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The number of pharmacies has been falling for years and fell further to 16,541 by the end of March - the lowest level since 1977.Â
With reporting by DPA.
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