Pharmacists want reliable e-prescriptions, Warken to boost pharmacies

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The future of pharmacies was the focus of the German Pharmacists' Day in Düsseldorf. While the President of the Federal Union of German Pharmacists' Associations (ABDA), Thomas Preis, denounced massive problems caused by supply bottlenecks, disruptions to e-prescriptions and unfair competition from abroad, Federal Health Minister Nina Warken presented the key points of a comprehensive pharmacy reform. The aim is to give pharmacies more responsibility, give them new scope for action and strengthen their role in healthcare provision.

E-prescription as a stumbling block

The hope that the electronic prescription would digitally simplify care has not yet been fulfilled. "Supply bottlenecks and ongoing failures of the e-prescription not only jeopardize the care of patients thousands of times a day, but also burden pharmacies with considerable additional costs and lost sales," warned Preis. Every pharmacy spends around 20 hours a week to compensate for supply bottlenecks. At the same time, pharmacies are threatened with retaxation by the health insurance companies for the slightest formal error. Preis therefore called for an end to this practice.

Foreign mail order companies criticized

Another problem is the competition from foreign mail order companies. These often circumvent legal requirements such as bonus bans or transport regulations, which not only distorts competition but also endangers patient safety, according to the pharmacists. "More and more people in our country are saying that there is no other area in our country in which our state allows itself to be so cheated as in the shipping of medicines from abroad," Preis criticized. Warken shared the criticism and emphasized that the existing regulations must be consistently enforced. Where infringements are not sufficiently sanctioned, they need to be tightened up.

Warken's reform plans: more responsibility for pharmacies

In her speech, Federal Health Minister Warken presented key points for a pharmacy reform. The aim is to strengthen the position of local pharmacies and expand them as a low-threshold point of contact. Among other things, new medical tasks are planned, according to which pharmacies will be allowed to offer simple diagnostic tests for the early detection of cardiovascular diseases and carry out more vaccinations – with inactivated vaccines. It is also planned that pharmacists will be able to carry out rapid tests and treat patients without a doctor's prescription – such as chronic patients with known long-term medication or uncomplicated minor illnesses.

In addition, pharmaceutical services are to be remunerated more and documented directly in the electronic patient record (EPR). In future, doctors should also be able to prescribe personalized services. Pharmacies are also to be allowed to adjust opening hours in line with demand, centralize prescriptions in branch networks and receive support in setting up branch pharmacies in rural areas. Remuneration is also to be improved, for example by doubling the emergency service flat rate. Warken also promised to remedy retaxation for formal reasons.

Electronic patient file (ePA) as the key

The electronic patient file is to play a central role in the reform plans, in which all services are to be recorded in future and documented transparently for doctors, pharmacists and patients – in order to prevent duplicate prescriptions, improve medication plans and enable a secure exchange of information, among other things. "Of course it is conceivable to give a patient emergency treatment without a prescription. But it has to be traceable in the ePA so that they don't have to go from pharmacy to pharmacy and obtain medication multiple times," explained Preis.

In the subsequent discussion with the editor-in-chief of the pharmaceutical newspaper, Alexander Müller, the lines of conflict became clear. In particular, the higher pharmacy reimbursement announced in the coalition agreement between the CDU/CSU and SPD will not be implemented this year. Warken referred to the tense financial situation of the statutory health insurance system and announced that it would not be implemented until it had stabilized – for Preis: "This emergency aid was long overdue and should no longer be delayed."

No home office for pharmacists

There was also a dispute over the doubling of the emergency service allowance. Warken wants to finance this measure from the fund for pharmaceutical services, which Preis strictly rejects: instead of promoting pDL, this would jeopardize its expansion. The planned expansion of skills for pharmaceutical technical assistants (PTAs) was also the subject of much debate. Following appropriate further training, they should be allowed to take on smaller substitutions if a pharmacist is absent at short notice. Preis warned against "breaking a taboo". Medicines are highly sensitive products for which responsibility should not be delegated to assistants. "No one would get on a commercial airplane if it said: today the flight engineer is flying, the pilot is in the home office," said Preis.

Despite all the differences, there is a consensus that pharmacies remain indispensable for healthcare. They are considered the first port of call, especially in rural areas, and should take more of the pressure off doctors' surgeries in the future. "We would rather not weaken local pharmacies, but rather strengthen them – with more personal responsibility, less bureaucracy and modern care," explained Warken. Citizens could obtain health information from them without an appointment, "personally on site and expertly". Preis added: "New services make sense, but without fair remuneration and economic security, there will be no sustainable future."

(mack)