German pharmacies halt fee agreement over unsustainable labor costs for critical drugs
The German Pharmacists' Association (DAV) has ended its provisional fee schedule for specialised pharmacy services. The decision follows a dispute with the National Association of Statutory Health Insurance Funds over labor fees for producing critical medical formulations. DAV claims the current payment of €100 per preparation no longer covers rising costs.
Around 300 pharmacies in Germany operate cleanroom labs that produce parenteral formulations. These include 1.9 million cytostatic preparations and 1.8 million other parenteral solutions each year. Together, these services generate over €6 billion in annual revenue.
In October 2022, an arbitration ruling set a uniform labor fee of €100 for certain formulations. However, DAV argues that inflation and higher operational expenses have made this rate unsustainable. The Berlin-Brandenburg State Social Court previously confirmed that pricing rules are not strict caps, but DAV maintains the fee still falls short of actual production costs.
After negotiations failed, DAV terminated the schedule on March 31. The next step is a legally required arbitration process under social security law. This will determine whether labor fees for these life-saving treatments will increase.
The termination leaves pharmacies and insurers without a temporary agreement. A formal arbitration will now decide on fair compensation for producing complex parenteral drugs. The outcome will affect hundreds of cleanroom labs and millions of patients relying on these therapies.
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