Germany's Bundestag approved a comprehensive pharmacy reform on Friday, granting pharmacies significantly expanded responsibilities in the country's healthcare system. The law, officially known as the Apothekenversorgung-Weiterentwicklungsgesetz, passed with the votes of the governing CDU/CSU and SPD coalition. The opposition Greens and AfD voted against it, while the Left party abstained.
Federal Health Minister Nina Warken (CDU) said the reform integrates pharmacies more broadly into the healthcare system through expanded vaccination services, diagnostic testing, and preventive care programs. The goal, she stated, is to strengthen pharmacies as a pillar of accessible, nationwide healthcare delivery.
Under the new rules, pharmacists will be authorized to administer all vaccines using inactivated vaccines, including those against tetanus and tick-borne encephalitis (TBE). Previously, pharmacies were limited to flu and COVID-19 vaccinations only.
Following appropriate medical training, pharmacists will be permitted to perform venous blood draws for diagnostic purposes, a responsibility previously reserved for doctors.
Patients with chronic conditions who need ongoing medication will no longer need a new prescription for every refill. Pharmacies may dispense their regular prescription drugs without requiring a fresh doctor's visit each time.
Pharmacies will also be able to provide prescription drugs for acute, uncomplicated forms of specific illnesses without a prior doctor's prescription, easing access for patients with minor health issues.
The reform introduces a new mandate for pharmacies to offer screening and prevention programs targeting cardiovascular disease, diabetes, and tobacco-related illnesses as part of their pharmaceutical services.
Rapid diagnostic tests for common pathogens will be available at pharmacies and approved care facilities, with the partial lifting of the requirement that only doctors can order such tests.
The pharmacy fixed fee, a flat-rate reimbursement pharmacies receive from health insurers to cover operating costs, will increase from the current 8.35 euros to 9.50 euros per dispensed prescription package starting next year.
Rural pharmacies will benefit from a new subsidy for partial emergency services during evening hours. The requirements for establishing branch pharmacies in underserved areas will also be relaxed, allowing new locations to open where access to medication is significantly limited.
In a pilot program, experienced pharmaceutical-technical assistants (PTA) will be permitted to temporarily manage a pharmacy for up to 20 days per year, with a maximum of 10 consecutive days. This measure requires regulatory approval and is designed to prevent pharmacy closures in regions facing staffing shortages.
The reform introduces the option for two people to jointly manage branch or subsidiary pharmacies, allowing for more flexible working arrangements with a clear division of responsibilities.
Pharmacies will be allowed to dispense an available in-stock medication when a discounted alternative prescribed by a doctor is unavailable. This rule will be introduced on a temporary basis and subject to evaluation.
Pharmacies will no longer face financial penalties for dispensing a substitute medication that matches the originally prescribed drug in active ingredient strength, package size, approved indication, and dosage form.
For patients, the reform means less reliance on doctor visits for routine healthcare. Prescription refills for chronic conditions, vaccinations, blood tests, and treatment for minor illnesses can now all be handled at the local pharmacy, saving time, reducing waiting lists, and bringing essential services closer to home, especially in rural areas.
Despite the coalition's support, the reform faced pushback from opposition parties and health insurers. Critics raised concerns about the additional costs that the expanded pharmacy services would impose on insured individuals. The Greens and AfD voted against the legislation, while the Left party chose to abstain, signaling reservations about specific provisions of the law.
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