Germany approves pharmacy reforms to expand vaccines, tests and prescriptions

Germany’s parliament backed a reform that could shift a slice of routine care out of doctors’ offices and into neighborhood pharmacies, letting pharmacists do more than flu and COVID shots. The plan would expand vaccinations to include tetanus and FSME tick-borne virus immunizations, add more testing, and in some cases allow certain prescription medicines to be dispensed without a doctor’s order.

Lawmakers approved the Apothekenversorgung-Weiterentwicklungsgesetz, or ApoVWG, on Friday, May 22, 2026, after earlier committee work and debate in the Bundestag. The cabinet had already signed off on the draft on December 17, 2025, and a public hearing before the health committee was set for March 4, 2026. The government says the reform is meant to reduce bureaucracy, use pharmacists’ expertise more broadly in prevention and routine care, and strengthen smaller and rural pharmacies that are under pressure from staffing shortages, structural change and declining profitability.

The policy is also a test of how far Germany is willing to modernize primary care by leaning on pharmacies as a pressure valve. Supporters see a practical answer to a system in which appointments are scarce, administrative friction is high and simple renewals can send patients back into long waits. If the rules work as intended, patients with long-running treatment plans could handle more of that work in a local pharmacy, while doctors focus on more complex cases.

That logic rests on hard numbers. Germany has about 17,000 pharmacies, or roughly 20 pharmacies per 100,000 inhabitants, and ABDA says the total has been falling in recent years. The sector is still dense by international standards, but the economics are fragile. That is why the government paired broader responsibilities with a promise of better operating conditions for owner-run outlets, especially outside major cities.

The push has also met resistance. On February 26, 2026, the Kassenärztliche Bundesvereinigung warned that transferring physician tasks to pharmacists could endanger patient safety and dilute medical competence. It also said medicines dispensed without a prescription would have to be paid out of pocket by patients, leaving some to return to doctors later to seek reimbursed prescriptions.

The Bundesrat took a different tack on January 30, 2026. It called for a basic cost subsidy for the first 20,000 prescription dispensings to support small pharmacies, but criticized easier rules for branch pharmacies and rejected a proposal that would have let experienced pharmacy technicians manage pharmacies in rural areas for up to 20 days. Dr. Andreas Philippi, the health minister in Niedersachsen, said pharmacy numbers have been falling for years and that rising operating costs, inflation and unadjusted dispensing prices are putting heavy pressure on the sector.

For Germany’s health system, the reform is more than an adjustment to pharmacy rules. It is a sign of how advanced health systems are trying to redistribute routine work as the supply of doctor time tightens, and whether that shift amounts to modernization or simply a stopgap.