The Dutch mail-order pharmacy DocMorris expects further growth from electronic prescriptions.
(Photo: Doc Morris )
Frankfurt The Dutch mail-order pharmacies Doc Morris and Shop-Apotheke fear for their market chances when electronic prescriptions are introduced in Germany next year. Because the previous draft law by the Federal Ministry of Health does not provide for a binding, fully digital redemption option, the senders see themselves at a great disadvantage compared to stationary pharmacies.
That is why the Dutch senders sent a complaint against Germany to the European Commission on Thursday, as the Handelsblatt learned exclusively in advance. The Commission is called upon to initiate new infringement proceedings against Germany because it “deliberately and unjustifiably” restricts market access for foreign online pharmacies and thus violates EU law.
In addition to the “delayed and discriminatory introduction of e-prescriptions”, the foreign senders are also concerned with the regulation, which was reintroduced in Germany in 2020, that foreign mail-order pharmacies are not allowed to give any bonuses on prescription drugs. According to Handelsblatt information, Federal Minister of Health Karl Lauterbach (SPD) also received a letter yesterday with the demands of the sender. “We want concrete assurances that the insured will also receive user-friendly and fully digital access to the online pharmacies when redeeming the e-prescription,” said Doc Morris boss Walter Hess to the Handelsblatt.
For the listed senders, it is about their growth opportunities in a potentially billion-dollar market. According to data from the market research institute IQVia, the market for prescription drugs in Germany grew by more than five percent to 40.3 billion euros last year. Mail-order pharmacies have an estimated share of about one percent.
With the introduction of the e-prescription, which according to the draft law is now to become mandatory from 2024, this share could increase to around ten percent in a few years, expect consulting firms such as Sempora and Dr. casque. However, this can only be achieved if the e-prescription can also be redeemed by the insured person via the online pharmacy.
So far, it can only be redeemed in pharmacies
In the previous model tests, insured persons could only use the e-prescription with a scanned paper printout from the doctor’s practice or with the e-prescription app from Gematik. Gematik has the legal mandate to promote the electronic health card and its infrastructure in Germany. An NFC-enabled smartphone and an NFC-enabled health card including a PIN number from the health insurance company are required to use this e-prescription app so that wireless data exchange can take place. So far, only a very small part of the population has access to this.
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The e-prescription can now also be redeemed via the electronic health card. In the future, this is to become the primary redemption method, which, according to estimates, could be used for up to 70 percent of the e-prescriptions issued in the long term. So far, however, it can only be redeemed via readers in the on-site pharmacies. The drug senders argue that this solution excludes online pharmacies.
However, in coordination with the Federal Ministry of Health, a digital procedure is currently being tested in various pharmacies, among other things, in which the e-prescription QR code can be scanned by a card terminal in the doctor’s practice and then redeemed via an app. “Setting up such a solution across the board may take years and therefore too long,” says Doc Morris boss Hess. “E-prescriptions must also be easily redeemable for the insured person via electronic health card at online pharmacies,” he says.
At the end of 2020, foreign online pharmacies had already complained that they had been discriminated against by the then Federal Minister of Health, Jens Spahn. This had brought a ban on discounts on prescription drugs on the way. The bonuses on prescriptions had made the Dutch mail-order pharmacies big over the past two decades. Because they were operating from abroad, they did not feel bound by German price maintenance for prescription drugs. With the 2020 bonus ban, sales of prescription drugs at Shop-Apotheke and Doc Morris have fallen significantly.
The European Commission had already opened infringement proceedings against the Federal Republic of Germany in 2013 because of the price maintenance applicable to prescription drugs in Germany because, in the Commission’s view, this conflicts with the free movement of goods within the EU. However, the procedure was discontinued in 2021.
At the time, the Commission had expressly recognized that the reintroduced bonus ban violated EU law. When justifying the termination of the procedure, however, she referred to her discretion, the burdens caused by the corona pandemic for pharmacies and the opportunities of digitization for the pharmacy market with a view to the start of e-prescriptions, which was already planned for 2022.
In the meantime, however, this start has been postponed by another two years, and the timetable for the introduction is also not certain according to the senders. This is one of the reasons why they want to put pressure on them with their complaint.
More: Karl Lauterbach – ePA to digitize healthcare.