German pharmacists demand fair pay as health system surplus hits €3.5 billion

Germany's statutory health insurance system recorded a €3.5 billion surplus in 2022. Yet, tensions are rising as pharmacists argue they have shouldered the costs while insurers benefit. Frank-Martin Welzig, a pharmacy owner in Lower Saxony, has publicly criticised the government's handling of the situation.

Since 2012, the fixed fee pharmacies receive for dispensing drugs has remained frozen at 7.08% of the purchase price. A minor increase to 7.3% is planned for 2025, but pharmacy associations like ABDA are pushing for a much larger rise—between 10% and 12%—to address soaring costs. They also want a full overhaul of the remuneration system and relief from staff shortages by 2026.

Welzig, who owns Hils Pharmacy in Delligsen, recently wrote to Health Minister Nina Warken, calling the current reform draft a 'slap in the face' to pharmacists. He claims the surplus was generated not by insurers but by pharmacies fulfilling discount contracts. These agreements add extra work and often lead to frustrated patients.

The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) has responded by stating that the surplus is still insufficient to rebuild reserves. Despite the financial gains, pharmacists argue they continue to bear the operational strain without fair compensation.

The dispute highlights the growing pressure on pharmacies, which face rising expenses and regulatory burdens. With no immediate increase in fees, the profession is demanding urgent reforms. The government's next steps will determine whether the system can balance cost control with fair support for pharmacists.