Pharmacy Strengthening Act: Enable fair competition

The Bundestag passed the on-site pharmacy strengthening law on Thursday, October 29, 2021. A key point is that European senders are no longer allowed to give discounts on prescription drugs. Important questions about the shipping of medicines

Health Minister Jens Spahn wants to strengthen local pharmacies with a law. In his opinion, however, banning the shipping of prescription drugs is out of date

© Getty Images / E + / simonkr

Since when has we been allowed to ship prescription drugs?

In 2004, under the then Federal Minister of Health Ulla Schmidt (SPD), mail order sales of prescription and non-prescription drugs were approved.

And what about in other European countries?

Most of the other European countries do not allow medication to be sent on prescription. Usually only over-the-counter medicines are allowed to be sent there.

Why do foreign mail order companies currently have a competitive advantage?

Four years ago, the European Court of Justice (ECJ) allowed mail order companies to give their customers discounts on prescription drugs. German pharmacists, however, have to adhere to the drug price regulation applicable in this country and are not allowed to give a discount.

A preparation on prescription costs the same in every German pharmacy. In order to stop the competitive advantage of European mail-order companies over domestic pharmacies, the former Federal Minister of Health Hermann Gröhe (CDU) wanted to ban the mailing of prescription drugs again.

The mail order ban is anchored in the coalition agreement. Why isn't the government doing it?

"In order to strengthen the local pharmacies, we are campaigning for a ban on mail order sales of prescription drugs," says the coalition agreement. Nevertheless, the current Federal Health Minister Jens Spahn (CDU) considers such a step to be out of date and "in terms of European law, but also politically imponderable".

The SPD parliamentary group does not support the mail order ban either, said Sabine Dittmar, the Social Democrats' spokeswoman for health policy. The ban did not find its way into the Pharmacy Strengthening Act, which was passed by the Bundestag on Thursday, October 29, 2021.

How do the German pharmacists assess that?

The Federal Association of German Pharmacists' Associations (ABDA) has long fought for a mail order ban on prescription drugs. After many discussions with the Federal Ministry of Health and various proposals, counter-drafts and statements, she is now supporting the reform package - although it does not contain the shipping ban. ABDA President Friedemann Schmidt assumes that such a step would not find a political majority at the moment.

Is that the position of all pharmacists?

Some still hope for the mail order ban. Pharmacy student Benedikt Bühler is also committed to this. He started a Bundestag petition on the subject in 2019. For him, the ban on the mail order business of prescription drugs is "the most promising way to ensure equality of prices". "Comprehensive, comprehensive patient care can only be ensured through retail pharmacies," says Bühler.

Many pharmacies took part in the petition, and their customers gave their signature on site. German citizens could also sign the petition on the Internet. More than 400,000 people supported the cause. The number of 50,000 necessary votes was clearly exceeded.

What are the effects of the petition?

The petition did not change anything in Spahn's draft law to ensure the nationwide supply of on-site pharmacies.

How does Jens Spahn intend to use the law to create fair competitive conditions?

With the law, the Minister of Health is moving price maintenance from pharmaceutical law to the Social Security Code, where national regulation is possible without the influence of the EU. Spahn refers to the principle of solidarity. It is currently being undermined by discounts from online pharmacies, since discounts only benefit individual customers and not the solidarity community.

European online pharmacies are no longer allowed to give legally insured persons any discounts for prescription drugs. The problem: this does not apply to those with private insurance or to self-payers. Discounts would still be possible.

Can the law still fail?

In the Federal Council, the Pharmacy Strengthening Act does not require approval. According to the Federal Ministry of Health, it is expected to come into force in December. However, it is still unclear whether the solution is legally compliant with the EU. The Federal Ministry of Health has been in talks with the European Commission for months. It remains to be seen whether the law will end up before the ECJ again after it comes into force because of concerns under European law.

How else should the pharmacies be strengthened?

The reform package also provides that pharmacies will receive extra money for additional pharmaceutical services. Examples of this are medication analyzes for patients who have to take many different drugs, intensive pharmaceutical care for cancer therapy or the supply of medicines to those in need of care at home. The courier service should be remunerated on a permanent basis.

When would the ABDA campaign for a shipping ban again?

If the on-site pharmacies are not sufficiently strengthened by the current legislative proposal, the ABDA wants to keep the shipping ban for prescription drugs as a political option for the future.