E-Rezept CardLink vs. App vs. eGK: Which Works Best for Your Pharmacy? (2026)
In 2026, the E-Rezept redemption landscape is mid-transition. CardLink is being retired. A new protocol called PoPP is rolling out. The eGK has established itself as the dominant in-pharmacy method — and paper printouts, despite less attention in the digital-first conversation, remain a significant part of daily operations. Understanding where things stand is essential for training your staff, setting patient expectations, and preparing for what comes next.
This guide breaks down every method clearly — what it is, how it works from your pharmacy's perspective, who uses it, and what its future looks like.
The Reality Check: What Patients Are Actually Using
Before diving into the mechanics, here's where things actually stand: according to ABDA's February 2024 survey of German pharmacies, the electronic health card (eGK) is by far the most widely used E-Rezept redemption method in-store. It requires nothing extra from the patient — just the card they already carry — and that simplicity has made it the clear frontrunner. Paper printouts with QR codes remain a significant share of daily redemptions, particularly in areas where doctor practices have standardised the printout workflow. App usage is growing but still low — adoption is held back by the setup process required for first-time users. CardLink is being phased out. That's the landscape in 2026. Here's how each method actually works.
Method 1: Electronic Health Card (eGK) — The In-Pharmacy Standard
The patient hands over their Gesundheitskarte (health insurance card). You insert it into your certified card terminal. Your AVS connects to the E-Rezept-Fachdienst and pulls all pending prescriptions linked to that card. You select the relevant prescription, dispense the medication, and the prescription is automatically marked as redeemed. No PIN required from the patient. No app, no QR code.
- A certified card terminal (stationäres Kartenterminal) at each dispensing counter
- An active TI connection (Telematikinfrastruktur)
- An updated AVS with E-Rezept module
The eGK is the most operationally clean method for in-store dispensing. It requires nothing from the patient beyond handing over a card they already carry. No confusion about apps, no fumbling with QR codes, no risk of the patient having deleted their prescription from an app. It works even when no other method does — and that reliability matters. The eGK is the long-term standard for in-store E-Rezept redemption. It has no planned phase-out date and is the method gematik and ABDA consistently promote as the primary in-pharmacy path.
Limitations
- In-store only — cannot be used to order remotely or from an online pharmacy
- Requires a physical card terminal at your counter (which you should have anyway)
- If a patient forgets their card, they need an alternative method
Method 2: Paper Printout with QR Code — Still Very Common
The doctor's practice prints a sheet with a DataMatrix QR code representing the digital prescription. The patient brings this to your pharmacy. Your staff scans the code — using the card terminal scanner or a connected scanner — and the AVS retrieves the prescription from the E-Rezept-Fachdienst. Same process as eGK from the pharmacy side, just triggered by scanning a code instead of reading a card.
This is the method your staff processes most often, even if it gets the least attention. The key thing to reinforce with your team: the paper is not the prescription. It's a token — a code that points to the digital prescription on the server. If the code is damaged or unreadable, the prescription still exists on the server and can be accessed via the patient's eGK. Patients don't always know this and can panic unnecessarily.
Limitations
- Relies on the doctor's practice printing the sheet — some patients forget it or lose it
- If the QR code is damaged, staff need to know the fallback (eGK retrieval)
- Still involves a physical piece of paper, which partially defeats the purpose of digitalisation
Method 3: E-Rezept App — Digital, Growing Slowly
The patient uses the official E-Rezept app, published by gematik and available on iOS and Android. Prescriptions from their doctor are automatically pushed to the app. In your pharmacy, the patient opens the app, selects the relevant prescription, and shows you a QR code. You scan it, retrieve the prescription, dispense, done. The app also allows patients to send prescriptions directly to a pharmacy for Click & Collect or delivery.
- Patients can see all their active prescriptions in one place
- Prescriptions from the last 100 days remain visible in the app (vs. the server's 100-day auto-deletion)
- Patients can create profiles for family members and manage prescriptions on their behalf
- Prescriptions can be shared directly with a pharmacy remotely — without visiting in person
- Integration with health insurer apps is increasingly available
The app presents the lowest friction for tech-savvy patients. For your staff, the process is identical to scanning a paper QR code — the scanner reads the code, the AVS retrieves the prescription. The difference is that the code comes from a phone screen instead of paper. The main challenge is patients who can't find their prescription in the app. Brief, patient guidance from staff is part of handling this method well.
Limitations
- Requires an NFC-capable smartphone and initial setup with a health card PIN
- Adoption remains low — most patients, especially older demographics, do not use it
- If the patient's battery is dead or screen is cracked, they need an alternative
Method 4: CardLink — Works Now, Ending January 2027
CardLink allows patients to redeem E-Rezepts entirely remotely — without visiting a pharmacy in person. Using a pharmacy's own app (not the gematik app), the patient holds their NFC-capable health card to the back of their smartphone. The phone reads the card and transmits the card data securely to the pharmacy's system via the TI. The patient also enters their card's CAN number (printed on the front of the card) and confirms via SMS code. The pharmacy retrieves the prescription and can dispatch the medication by post.
CardLink has been used primarily by online pharmacies — DocMorris, Redcare, and others — to allow patients to order prescription medication remotely. It was never primarily an in-pharmacy tool. Some brick-and-mortar pharmacies have used it for pre-ordering, but adoption there has been limited.
Unless your pharmacy has an active online dispensing service, CardLink is likely not a major part of your daily operations. Its primary relevance for local pharmacies has been in pre-ordering scenarios — a patient places an order remotely before collecting in store. If your pharmacy's digital platform uses CardLink, you need to plan for its replacement.
Limitations
- Being retired — no long-term viability
- Requires the patient to have an NFC phone, their health card, and their CAN number
- Originally designed for online pharmacies, not in-store use
- Security concerns raised by some pharmacy associations around remote card use
What's Replacing CardLink: PoPP Explained
PoPP — Proof of Patient Presence — is gematik's next-generation protocol for confirming a patient's identity and care context when accessing prescription data. It's being built and operated by RISE, commissioned by gematik in late 2025.
How PoPP works
Instead of transmitting health card data remotely (as CardLink does), PoPP generates a cryptographically secured token that confirms the patient is in a specific care context — whether in a pharmacy, a telemedical consultation, or another healthcare setting. This token is issued via the PoPP service, which is accessible over the public internet after the patient authenticates using their GesundheitsID or health card. Think of it as a digital proof of presence — a secure, time-limited key that confirms the care interaction without needing the physical card to travel across the network.
- July 2026: PoPP rolls out to first pharmacies.
- August–January 2027: Parallel transition period — CardLink and PoPP both operational.
- January 31, 2027: CardLink fully retired. PoPP becomes the standard for remote E-Rezept redemption.
- End of 2026+: PoPP extended to telemedical use cases.
What PoPP means for your pharmacy
If your pharmacy has no online dispensing service and doesn't use CardLink, PoPP has no immediate operational impact for you. Monitor your AVS provider's update roadmap for PoPP integration. If you do have a patient-facing digital platform, work with your provider to understand the migration path before August 2026.
Side-by-Side Comparison
| Feature | eGK | E-Rezept App | Paper Printout | CardLink |
|---|---|---|---|---|
| Works in-store | ✅ Yes | ✅ Yes | ✅ Yes | ⚠️ Being phased out |
| Works remotely / online | ❌ No | ✅ Yes | ❌ No | ✅ Until Jan 2027 |
| Requires app / smartphone | ❌ No | ✅ Yes | ❌ No | ✅ Yes |
| Requires PIN | ❌ No | ✅ Setup only | ❌ No | ⚠️ CAN + SMS code |
| Pharmacy needs terminal | ✅ Yes | ✅ Scanner | ✅ Scanner | ❌ No (online) |
| Adoption rate (2024) | Dominant (ABDA: #1 in-store) | Low | Common | Online pharmacies mainly |
| Future status | ✅ Long-term standard | ✅ Long-term | ✅ Still valid | ❌ Ends Jan 2027 → PoPP |
Which Method Should Your Pharmacy Focus On?
The honest answer: all of them, but not equally.
For in-store dispensing — prioritise eGK
The eGK is your most reliable, most patient-friendly in-store method. It requires nothing from the patient beyond their standard health card. Make sure your card terminal is positioned well, firmware is updated, and all staff can operate it confidently.
For paper printouts — train for the fallback
Paper is still what most patients bring. The priority here isn't to push patients away from paper — it's to make sure staff understand that the paper is just a pointer to a digital record, and know how to help when the code doesn't scan.
For the app — be patient-ready, not app-dependent
App usage will grow, particularly among younger patients. Your staff doesn't need to be app trainers, but they should know the basics of how to help a patient who's confused about finding their QR code.
For CardLink and PoPP — plan, don't panic
Unless CardLink is central to your digital offering, this transition doesn't require urgent action. But if you have an online platform or patient-facing app, get clarity from your software provider now on their PoPP roadmap. The August 2026 parallel window is the right time to migrate.
A Note on Patient-Facing Digital Presence
All four redemption methods — and PoPP when it arrives — work best when they're connected to a pharmacy's wider digital infrastructure. A patient who can pre-order via your pharmacy app using their E-Rezept, collect in store, and receive follow-up communication digitally has a fundamentally different experience than one who shows up with a paper slip and waits in a queue. Platforms like Mediloon are built to connect these pieces for German pharmacies — E-Rezept integration, pharmacy app, Click & Collect, digital customer communication — in a single maintenance-free system. As the redemption method landscape evolves through the PoPP transition, having a platform that stays current removes the burden of managing each change yourself.
About Mediloon
Mediloon is a Leipzig-based healthtech company building digital infrastructure for German pharmacies — including E-Rezept integration, pharmacy apps, Click & Collect, Botendienst coordination, and the Medi AI assistant. This article is part of Mediloon's pharmacy digitalisation guide series. It is intended as general operational and regulatory information. For specific legal or compliance queries relating to AI systems in your pharmacy, consult your regional Apothekerkammer or a qualified legal advisor.