Prescription drug discounts should be discontinued according to the ABDA president's call
In a recent call to action, Thomas Preis, the President of the Federal Association of German Pharmacists' Associations, has urged Federal Health Minister Nina Warken to take decisive steps against discounts offered by foreign online pharmacies on prescription medications.
The regulation of discounts by foreign online pharmacies on prescription medications in Germany is stringent, designed to protect patients and maintain pharmacy neutrality. Under Section 11(1a) of the German Pharmacy Act (Apothekengesetz, ApoG), the collection and forwarding of prescriptions in exchange for payment or other benefits is prohibited. This means that telemedical platforms and pharmacies must respect patients’ freedom to choose their pharmacy without undue influence or financial incentives tied explicitly to forwarding prescriptions.
While German law forbids paying pharmacies or platforms directly to forward or broker prescriptions, a ruling by the Federal Court of Justice in February 2025 clarified that platforms may charge a fixed monthly fee to partner pharmacies without violating this prohibition, provided the fee is not linked to the number or value of prescribed medicines sold. Platforms must also not restrict the freedom of the patient to choose any pharmacy, even if only partner pharmacies are listed.
Regarding discounts offered by foreign (non-German) online pharmacies, while German pharmacy law is primarily focused on domestic actors’ conduct, the regulation involves protecting the neutrality and transparency of the supply chain. Patients do have the right to obtain prescription medicines from abroad (personal import), but online pharmacies must comply with German pharmacy rules if they aim to dispense directly to German patients, which effectively limits aggressive discounting practices tied to prescription forwarding or brokering.
The introduction of electronic prescriptions (e-prescriptions) in Germany since 2022 facilitates online pharmacy access while maintaining regulatory controls on prescription transmission and dispensing. These digital systems enhance transparency and traceability, allowing better enforcement of pharmacy laws.
In summary, foreign online pharmacies seeking to offer discounts on prescription medications to German patients must adhere to strict pharmacy law requirements, avoiding any financial arrangements that could be construed as exchanging prescription forwarding for payment, and respecting patient choice.
Thomas Preis, the President of the Federal Association of German Pharmacists' Associations, has expressed concerns about the impact of these discounts on the German pharmacy sector. He argues that the price binding must not be undermined by bonuses or discounts, otherwise, it could lead to a ruinous price war. Preis believes this is a clear violation of the law and states that the state must intervene and punish and prevent this behavior. He also emphasises the need to stop foreign online pharmacies to ensure the security of the supply in Germany, as the decline of pharmacies is a fact that must be urgently addressed. Since 2008, a total of 4,500 pharmacies have been closed, corresponding to 21 percent.
In more and more cities, there are increasingly districts without pharmacies, a situation that Preis warns could lead to potential consequences of supply bottlenecks leading to exorbitant prices. He calls for higher remuneration for pharmacies and urges the state to prevent foreign online pharmacies from operating in the German statutory health insurance system. Operating costs such as energy or wage costs have exploded, according to Preis, making it increasingly difficult for pharmacies to remain economically viable.
[1] Source: Federal Court of Justice ruling (February 2025) [2] Source: Introduction of e-prescriptions in Germany (2022)
- To ensure the longevity of the German pharmacy sector, Thomas Preis, the President of the Federal Association of German Pharmacists' Associations, proposes higher remuneration for pharmacies and the prevention of foreign online pharmacies from operating within the German statutory health insurance system.
- In a bid to maintain pharmacy neutrality, Section 11(1a) of the German Pharmacy Act (Apothekengesetz, ApoG) prohibits the collection and forwarding of prescriptions in exchange for payment or other benefits, allowing telemedical platforms and pharmacies to respect patients’ choice without undue influence.
- In his call to action, Preis argues against price wars prompted by bonuses or discounts offered by foreign online pharmacies, asserting that these practices undermine pharmacy regulations and could result in supply chain security issues and potential price hikes in specific districts without pharmacies.
- As mental health, fitness-and-exercise, health-and-wellness, therapies-and-treatments, nutrition, and medicare are crucial aspects of a balanced lifestyle, it is essential for the German government to protect the legislation that safeguards the pharmacy sector, ensuring that citizens have access to affordable and safe prescription medications while safeguarding the integrity of local pharmacies.
