Health: What benefits do more flexible guidelines bring for pharmacies?

The network of pharmacies in Germany is becoming increasingly sparse. In order to maintain the range of services for patients, especially in rural areas, the requirements for pharmacies are to become much more flexible according to plans by Federal Health Minister Karl Lauterbach (SPD). “Action is needed to ensure that the comprehensive supply of medicines continues to be secured in the medium and long term,” says a draft of the ministry’s pharmacy law.

It is intended to relax requirements such as opening hours and the presence of pharmacists and enable new digital solutions. The health insurance companies support the plans, but the pharmacy industry has already expressed strong opposition.

The number of pharmacies has been shrinking for some time. At the end of March there were 17,429, 142 fewer than at the end of last year. Closures are currently continuing, explained the ministry. The reasons for this are also a lack of skilled workers and a migration of practices in rural regions. The aim is therefore to strengthen pharmacy locations in poorly supplied areas and also to make it easier to set up new ones. An overview of the key points of the draft, which is expected to be presented to the Bundestag in the second half of the year.

opening hours

Until now, pharmacies have been required to be “on call at all times” with possible exemptions, which result in fixed opening hours. This should be able to be handled more flexibly in order to adapt to staff resources and the needs of local care, as the draft states. Instead of the requirement to be open on weekdays from 8 a.m. to 6.30 p.m., in future they should be open “seven hours during normal local business hours” – and on Saturdays, instead of the fixed opening hours of 8 a.m. to 2 p.m., there should be a corresponding period of four hours.

Branches

In the future, it will be possible to have “branch associations” consisting of a main pharmacy, up to three branches and a maximum of two additional “branch pharmacies”. To make it easier to set up branches, they should be able to be located over a larger area than before. In an association, a pharmacy should also be able to carry out tests and manufacture medicines centrally. In places with poorer drug supplies, requirements for branch pharmacies, such as the space required, should be relaxed. It should also be possible for them to be open for just four hours a day.

digitalization

“Telepharmacy” is to be expanded via interactive video connections. This will enable a pharmacy to open even if the pharmacist is not on site, but in another pharmacy in the network – and can provide advice via the digital connection if necessary. However, the pharmacy manager must be present in person for at least eight hours per week. Otherwise, experienced pharmaceutical technical assistants should also be able to be there in this context.

compensation

Among other things, the draft states that “fee incentives” for locations in rural regions and a fairer distribution of fees are planned. To this end, the surcharge per pack of medicine that is paid during emergency service hours is to be increased from 21 to 28 cents. Planned effect: Since pharmacies in regions with few other pharmacies have emergency services more often, they benefit particularly. This means that 50 million euros more will be available each year for emergency service remuneration.

Vaccinations

Additional vaccinations should also be available to patients in pharmacies – in addition to corona and flu vaccinations, standard vaccinations against tetanus, diphtheria and polio, for example.

Reactions

The umbrella organization of statutory health insurance companies welcomed the plans, which pointed the way to a modernization of the structures. “It is of no use to people in rural areas if, as has been the case so far, pharmacy owners in main train stations and shopping streets in big cities earn even more money,” said spokesman Florian Lanz to the German Press Agency. Therefore, smart concepts are needed for a fair redistribution between the very different pharmacies.

The health insurance association proposes a “supply bonus” for pharmacies in rural areas and on the outskirts of town that sell fewer drugs than city pharmacies in the city center. “In concrete terms, this means that there should be more money in towns and rural areas for the amount of drugs dispensed that is necessary for a pharmacy to run profitably. Anyone who dispenses even more drugs will receive slightly less per pack than today,” explained Lanz.

The Federal Association of German Pharmacists, on the other hand, has already warned of a “destructive reform that will abolish the provision of pharmacists in local pharmacies and put tens of thousands of jobs at risk.” The industry has been demanding fee increases for some time now due to the strained financial situation of many pharmacies, which have long been lacking.

The ministry made it clear that it wanted to stick to its plans. The department said that an expansion of the range of services would only happen if people were honest. Small pharmacies were unable to afford the costs required to open a branch.