Kippels: €9.50 via Pharmaceutical Services Fund Still Under Discussion
Germany plans €9.50 pharmacist fee hike amid funding debates
In a video statement at the Future Congress for Public Pharmacies, Parliamentary State Secretary Dr. Georg Kippels emphasized that the Federal Ministry of Health (BMG)—and particularly Minister Nina Warken (both CDU)—remains deeply committed to "continuing dialogue and engagement with pharmacists," even amid critical voices. Discussions are ongoing about potential ways to secure the €9.50 fee.
"Of course, I cannot say today that it's already done," Kippels acknowledged. While inclusion in the coalition agreement marked a crucial step toward implementing the fee increase, he noted, "the agreement itself is not yet legislation. Unfortunately, it is embedded in a highly complex landscape of competing interests."
On one hand, the Pharmacy Reform Act is currently moving through parliamentary proceedings. The BMG's decision to address the fixed fee, the emergency allowance increase, and the negotiated solution—meant to be permanently established afterward—via regulatory measures rather than legislation stems from jurisdictional considerations. "It's simply a different path with the same legal force, the same regulatory content, and the same permanence—just within a different framework," Kippels explained.
The draft regulation currently includes the negotiated solution and the lifting of the cash discount ban, with the fee increase also intended to follow via regulation. Kippels stressed that there is no doubt about the government's seriousness, a point Minister Warken has reiterated multiple times. "Right now, we are in the middle of the notification process required for regulations."
BMG Does Not Decide Alone
The BMG cannot unilaterally resolve these issues, Kippels noted, as coordination with other stakeholders—particularly the Finance Ministry and, regarding drug pricing regulations, the Economy Ministry—is essential. This necessity complicates the process. It also affects funding for pharmaceutical services (pDL), where the €9.50 fee could potentially be co-financed through this mechanism.
While €950 million is a substantial sum, Kippels acknowledged that physicians' associations (KBV) and statutory health insurers (GKV) have already taken similar steps. "This is precisely what we aim to introduce going forward to rectify past shortcomings," he said. Unlike the physicians' agreement, however, the current pharmacy draft requires the negotiated fee to be implemented via BMG and Economy Ministry regulations—without a binding obligation in the draft itself. Kippels did not comment on this discrepancy.
"In many respects, the proposed regulation—both directly and indirectly—will improve the financial situation," he continued. Yet he recognized the economic pressures facing pharmacies and the declining number of local outlets. "That's why I want to reiterate clearly: the adjustment process is underway."
Kippels Remains Optimistic: No Mediation Committee Needed
Next week, final details of the law will be discussed in so-called rapporteur talks. "We are confident that no further objections will arise from the federal states—at least not on remuneration—which would otherwise risk triggering the mediation committee," Kippels said.
Addressing other contentious issues, such as pharmacy technician (PTA) representation and branch pharmacies, Kippels defended the BMG's position, as he had in the Bundesrat: "We may disagree on the assessment, but the ministry remains convinced that, given the growing skilled labor shortage and demographic shifts reducing the number of pharmacy owners, we need more flexibility." He emphasized that these measures would be optional: "No one is forced to use them." The PTA representation model, he added, is a pilot project: "Either it proves unsuccessful, or it won't be adopted."
Reform Brings Many Positive Changes
In his closing remarks, Kippels also highlighted the positive aspects of the proposed legislation: "This means a significant reduction in the risk of zero-rate taxation, changes to the options for reporting drug shortages, and the ability to quickly address gaps in patient care—such as on weekends or before holidays. And, of course, we also want to strengthen pharmaceutical services and preventive care."
All of this, he emphasized, should become a reimbursable part of pharmacy operations in the future. "What's important is that, as we have in the past, we continue to engage in regular dialogue on the various positions."
He acknowledged that protests were a constitutional means of expressing opinions, and suggested they might even have a positive effect by making the broader public more aware of the vital role local pharmacies play in healthcare—rather than assuming that the convenience of online pharmacies would secure the future of patient care. The draft law also includes stricter controls on mail-order prescriptions, aiming to "level the playing field," as he put it.
"We will most likely hold the public hearing on the bill on March 4. It is quite possible that all deliberations will be completed and approved by April, or by May at the latest, allowing us to begin implementation," Kippels concluded.
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