Germany has seen a significant decrease in pharmacies over the past five years, with nearly one in ten shutting down. Experts warn that this trend will soon impact patient care, and government reform plans are facing criticism.
Pharmacy closures impacting patient care
Germany is experiencing a rapid decline in its number of pharmacies. According to the Federal Association of German Pharmacists’ Associations (ABDA), about one in ten pharmacies has closed since 2018, with some regions losing up to one-third of their pharmacies. Experts predict that patients will soon feel the effects of these closures.
Nicolas Klose, head of Klose Consulting, which advises pharmacies on employee recruitment, emphasizes the critical role of pharmacies beyond just dispensing medications. “Pharmacies are also important for personal health consultations,” he says. The decrease in pharmacy numbers could lead to reduced medication availability and increased strain on remaining pharmacies, particularly affecting elderly and chronically ill patients who depend on regular medication.
Reasons behind the closure of pharmacies in Germany
According to a comprehensive review by industry experts, the closures of pharmacies in Germany are driven by several factors:
- Increasing online transactions: More people are managing their prescriptions and health needs online, reducing the demand for physical pharmacy locations.
- Financial pressures: Many pharmacies struggle with financial sustainability due to stagnant fees and increasing operational costs. This economic strain makes it difficult for some pharmacies to remain open.
- Demographic shifts: Changes in demographics, including the aging population and shifting health needs, affect how and where pharmacies operate. Some areas with declining populations or changing health service patterns may not support as many pharmacies.
- Regulatory changes: New regulations and reforms, such as the introduction of “Pharmacy Light” models with reduced staffing, are reshaping the pharmacy landscape. These changes aim to address the shortage of qualified professionals but also lead to the consolidation of services.
- Urban-rural disparities: Pharmacies in rural areas are particularly vulnerable due to lower customer volumes compared to those in urban centers. This disparity contributes to the higher closure rates in less populated areas.
These factors combined lead to the closing of pharmacies, particularly affecting smaller and rural locations.
Calls for increased funding and criticism of reform plans
ABDA is calling for an increase in pharmacists’ fees, which have been stagnant for over a decade. ABDA Vice President Mathias Arnold urges, “Pharmacies need an increase in their long-stagnant fees.” Support for this call comes from Fred-Holger Ludwig, chairman of the CDU Seniors’ Union, who criticizes the planned pharmacy reform law. Ludwig says, “The government must start considering the older population and not govern against them.”
Currently, Health Minister Karl Lauterbach (SPD) is working on a comprehensive pharmacy reform. This includes adjustments to pharmacy fees and the introduction of “Pharmacy Light” models, which would be staffed by pharmaceutical-technical assistants (PTAs) rather than licensed pharmacists. These PTAs could consult with pharmacists via video call to address the shortage of qualified professionals.
Pharmacy consultant Klose sees both advantages and disadvantages in this model. “While these pharmacies might be more cost-effective and improve accessibility, the quality of services and consultations may be compromised,” he says. Additionally, there could be market distortions if these “Light Pharmacies” receive state subsidies or regulatory exemptions, potentially putting traditional pharmacies under further pressure.
Regional differences and political disputes
SPD health policy spokeswoman Heike Baehrens supports the reform, noting that reducing bureaucracy and expanding competencies for pharmacists and PTAs could strengthen the pharmacy sector. “The reform aims to improve the economic conditions for pharmacies,” Baehrens says.
However, the Green Party’s Paula Piechotta highlights the varying regional impacts of the pharmacy decline, arguing that blaming the federal government alone is too simplistic. “Regional factors play a crucial role in the development of pharmacy closures,” Piechotta states.
Meanwhile, the FDP is critical of the reform proposals, with Andrew Ullmann, the FDP’s health policy spokesman, arguing that the current plans fail to address quality issues in pharmacy care. Ullmann calls for a new compensation model and expanded pharmaceutical services, similar to the fee schedule for doctors. “Significant changes are needed to improve care,” he concludes.
