Key points at a glance
- The fixed fee for a prescription-medicine pack is to rise from €8.35 to €9.00 from 1 July 2026.
- A second step to €9.50 is envisaged from 1 January 2027, as promised in the coalition agreement.
- The regulation is described as having been finally published in the Federal Law Gazette.
- In the opposite direction, the statutory health-insurance discount is planned to increase from €1.77 to €2.07 in 2027, reducing the gross profit of an average pharmacy by roughly €10,300 per year.
- The reform creates concrete strategic tasks for pharmacy owners.
What is the pharmacy fixed fee?
The pharmacy fixed fee, officially the pack fee, is the fixed amount a pharmacy receives for each prescription-medicine pack dispensed to a person covered by statutory health insurance. It forms part of pharmacy remuneration under the German Medicines Price Ordinance and is a major revenue component for most pharmacies.
Remuneration for statutory-insurance prescription medicines consists of:
- the fixed fee: previously €8.35, then €9.00 and, under the announced second step, €9.50 from 2027
- a percentage mark-up: currently three per cent of the purchase price and intended to fall gradually to two per cent
- minus the statutory health-insurance discount: currently €1.77 and planned at €2.07 from 2027
The fee increase is therefore real, but other measures partly offset it.
The figures: what does the increase mean for an average pharmacy?
Depending on location and structure, an average pharmacy dispenses approximately 40,000 to 60,000 prescription packs per year to statutory-insurance patients.
Stage 1: from 1 July 2026 (€9.00)
- additional revenue per pack: €0.65
- at 50,000 packs per year, the half-year effect would be €16,250 in the second half of 2026
- according to Pharmazeutische Zeitung, an average pharmacy would generate about €13,500 more gross profit in the second half of 2026 after the reduced percentage component for high-priced medicines is taken into account
Stage 2: from 1 January 2027 (€9.50)
- total additional revenue per pack compared with the previous level: €1.15
- at 50,000 packs per year: a theoretical €57,500 increase
- however, the statutory health-insurance discount is planned to rise by €0.30, from €1.77 to €2.07
- 50,000 packs multiplied by €0.30 equals a €15,000 counter-effect; industry estimates put the average reduction at around €10,300
- the net effect from 2027 remains positive, but is smaller than the headline figure suggests
Overall assessment
For a typical pharmacy dispensing 50,000 statutory-insurance prescription packs, the annual net effect from 2027 could be approximately €40,000 to €45,000 compared with 2025, depending on the share of high-priced medicines, the final discount rules and staff costs.
What the higher statutory health-insurance discount really means
A detail easily missed in public debate is that the second fee step is accompanied by a proposed increase in the statutory health-insurance discount from €1.77 to €2.07 per pack.
Thirty cents sounds modest, but at 50,000 packs it represents €15,000 less gross profit a year. Industry calculations from Treuhand put the average effect at approximately €10,300 per pharmacy.
Higher ancillary staff costs may add to the pressure. The source article cites a further approximately €800 per pharmacy per year in connection with the planned change in the social-security contribution ceiling and mini-job rules.
The fee increase is a genuine improvement, but it does not resolve every commercial challenge. Pharmacy structures and processes still need active optimisation.
What else the pharmacy reform contains
The Pharmacy Supply Development Act covers more than remuneration. The article identifies the following new rights and tasks:
- Temporary branch cover by pharmacy technicians: under defined conditions and initially in trials, qualified technicians could temporarily manage a branch, particularly in rural areas.
- Expanded pharmaceutical services: medication-safety work, medication reviews and assisted telemedicine are to be strengthened.
- Vaccination by trained staff: appropriately trained pharmacy technicians and pharmacy interns may receive expanded roles in vaccination services.
- Annual remuneration negotiations: the German Pharmacists’ Association and the National Association of Statutory Health Insurance Funds would negotiate pharmacy remuneration regularly using relevant indices.
Pharmacies that qualify their teams and establish billable services can create additional revenue streams that do not depend solely on prescription-pack volume.
How the fee increase affects pharmacy valuations
For owners considering a sale, succession or expansion, the fixed-fee increase can affect valuation directly.
Many pharmacy valuations use an earnings-based method. If sustainable operating profit rises, the enterprise value can also increase.
For illustration:
- assumed additional annual net earnings of €40,000 from 2027
- an assumed market multiple of 2.5 to 3.5 times operating earnings
- a theoretical additional sale value of €100,000 to €140,000
Owners planning an exit within two to three years may therefore benefit from stabilising earnings, establishing pharmaceutical services and optimising procurement before going to market.
By contrast, pharmacies with less than €2 million in annual revenue and no clear specialist position may remain structurally vulnerable. The fixed fee alone cannot rescue an economically distressed business.
Five practical recommendations from tiger.PHARMA
1. Reassess the business now
The higher fee changes the profit-and-loss account, tax planning and potentially the enterprise value. Owners considering a sale or expansion should update their financial model.
2. Use the potential of pharmaceutical services
Medication reviews, medication-safety services and expanded advice can generate additional planned revenue if the team and processes are properly prepared.
3. Reconsider the high-cost-medicine strategy
A reduction in the percentage mark-up particularly affects pharmacies with a high share of expensive medicines. Their margin model should be recalibrated.
4. Include the 2027 discount in planning
The higher statutory health-insurance discount should be included in liquidity forecasts, investment decisions and contracts.
5. Choose the sale window strategically
Owners considering an exit should assess how the higher fee, operating improvements and buyer demand affect the appropriate timing. tiger.PHARMA supports projects from valuation to completion.
Conclusion: a genuine improvement with unresolved questions
The 2026 and 2027 fixed-fee increases would be the first substantial improvement in pharmacy remuneration for many years. They provide additional room and a more realistic basis for future remuneration negotiations.
Nevertheless, rising staff costs, the increased statutory health-insurance discount, additional service obligations and a difficult labour market mean that pharmacies must be managed strategically rather than merely administered.
Those who adjust the business model early can benefit; those who wait risk losing room to manoeuvre.