German Health Funds Back Pharmacy Reforms but Warn of Rising Costs

The Association of Substitute Health Funds (vdek) has given broad support to the Pharmacy Supply Development Act (ApoVWG). While backing key reforms, it has raised concerns over potential cost increases for statutory health insurance (GKV). The organisation also proposed changes to funding mechanisms for emergency pharmacy services.

Since 2013, pharmacies have received €550 per full emergency service shift. An extra €2.50 fee applies for patients attending between 8 PM and 6 AM on weekdays, or all day on Sundays and public holidays. The vdek supports plans to raise these allowances and introduce subsidies for partial emergency services.

The association also endorses the self-governance negotiation model for remuneration. However, it seeks clearer rules to prevent excessive spending growth. To fund higher emergency service payments, the vdek suggests dissolving the Fund for Pharmaceutical Services (pDL) and using its unused reserves instead of adding a new per-pack surcharge.

Criticism was directed at expanded substitution rules in the draft law. The vdek argues these changes are unnecessary and threaten cost efficiency. It also opposes the removal of zero-price retroactive adjustments, warning this could disrupt rebate settlements and cost reviews.

Another concern is the broader discretion given to pharmacists in drug selection. The vdek believes this will push up GKV costs, particularly through the expansion of the pDL and wider medication choices.

The vdek's response highlights support for structural reforms but underlines financial risks from new substitution rules and pharmacist discretion. It calls for unused pDL funds to cover emergency service increases rather than introducing additional charges. The proposed changes could significantly impact GKV spending in the coming years.