The Future of the German Pharmacy: Trends for 2026 and Beyond
The cause is not a mystery. Fixed compensation has risen just once in 22 years — a 3.1% increase in 2013 — while operating costs have climbed 65% in the same period, according to ABDA. At the same time, the top four online pharmacy players (DocMorris, Redcare, apo.com Group, Atida) have captured 58.1% of Germany's OTC mail-order market by package volume (2023 data) and the top players are growing at roughly 15% annually — structural advantages that a single-location pharmacy cannot match on price.
The pharmacies that survive this decade will not do so by outpricing DocMorris or Redcare. They will survive by doing what mail-order structurally cannot: delivering pharmaceutical expertise, same-day access, and personal continuity — amplified by digital tools that extend their reach beyond the counter.
This article maps the trends that will define the German pharmacy from 2026 onwards — what's already happening, what's coming, and what it means for you as a pharmacy owner.
Trend 1: The E-Rezept Infrastructure Is Being Rebuilt From the Ground Up
The E-Rezept has been mandatory since January 2024, but the underlying infrastructure is still mid-evolution. Two major transitions are coming in 2026–2027 that every pharmacy must prepare for.
PoPP replaces CardLink by January 2027
CardLink — the technology that allows patients to present their health card via smartphone NFC to access their E-Rezept remotely — is being retired. CardLink licences expire on January 31, 2027. Its replacement is PoPP (Proof of Patient Presence), which works alongside the GesundheitsID. The PoPP rollout follows a staged timeline: Stage 1 launches mid-2026, and Stage 2 arrives by end of 2026. From August 2026 through January 2027, CardLink and PoPP will run in parallel. After January 31, 2027, CardLink is switched off. Action: Contact your pharmacy management software (PVS) and pharmacy app provider now. Ask explicitly: 'What is your PoPP integration timeline?' If they can't give you a date, escalate or consider switching providers before mid-2026.
BtM prescriptions go fully digital
From Q2 2026, controlled substance (BtM) prescriptions must be issued electronically, even for private patients (PKV). This eliminates the three-part paper BtM form. Verify with your PVS provider that your system is ready.
Trend 2: The ePA Becomes a Live Medication Management Tool
The elektronische Patientenakte (ePA) was rolled out to all statutory patients under the 'ePA für alle' mandate beginning January 15, 2025. By mid-2026, it is no longer just a passive document repository — it is becoming an active clinical tool.
The eML: a medication list you can see and act on
The elektronische Medikationsliste (eML), available in the ePA since April 29, 2025, automatically records every prescription issued and dispensed via E-Rezept. For pharmacists, this means patients arrive at the counter with a complete, accessible medication history.
eMP editing: the pharmacist's new consultation superpower
From March 2026, pharmacists can edit the elektronischer Medikationsplan (eMP) directly. Full nationwide rollout follows in Q3 2026. This means pharmacy consultation can be documented, made visible to GPs, and carried with the patient. A mail-order pharmacy processes the prescription. A Vor-Ort pharmacy can review it, identify interactions, and be named in the patient's health record.
ePA 3.0 and automated interaction checks
The ePA 3.0 iteration adds automated drug interaction checking built into the ePA itself, creating compliance obligations and opportunities to flag interactions the GP missed.
Trend 3: AI Goes From Experiment to Infrastructure
As of April 2025, only 13% of German pharmacy owners were using AI tools, but 77% believed AI has the potential to improve care. The gap between belief and adoption is closing fast.
What AI in pharmacies actually looks like in 2026
• Chatbot triage: Handling routine queries 24/7 without staff involvement. • Repeat prescription automation: Pre-processing requests for pharmacist sign-off. • Stock optimisation: Predicting demand to reduce out-of-stocks. • Interaction alerts: AI-powered checking integrated into dispensing.
The legal boundary: EU AI Act from August 2026
The EU AI Act applies its transparency obligations (Article 50) from August 2, 2026. Any AI chatbot must clearly disclose that patients are interacting with an AI system. Critically, §20 ApBetrO (Beratungspflicht) remains unchanged: pharmaceutical consultation cannot be delegated to AI.
Trend 4: The OTC Competitive Gap Is Structural — and Getting Wider
The top four online pharmacy players collectively held 58.1% of Germany's OTC mail-order market by package volume in 2023. These are structural advantages that a single-location pharmacy cannot match on price.
Where local pharmacies win
• Same-day dispensing: For acute conditions, local pharmacies provide medication in minutes. • Pharmaceutical consultation: A trained pharmacist who remembers your history is worth more than a warehouse pick list. • Botendienst: Combines the convenience of online with the speed of a local service. • Compounding (Rezeptur): Custom-compounded medications cannot be ordered online. The winning model is "local pharmacy + digital tools" (app, Click & Collect, Botendienst, chatbot).
Trend 5: Pharmacy Closures Are Creating Opportunity
502 German pharmacies closed in 2025. Every closed pharmacy leaves behind a patient base. Pharmacies within the catchment area will see new patient registrations — but only if those patients can find them. Digital visibility — a Google Business Profile, a findable website, an app listed in local search results — determines which surviving pharmacy captures those patients.
Trend 6: Automation Hardware Makes Staff Time Go Further
The European pharmacy automation market is growing, driven primarily by staff shortages and EU traceability mandates. Robotic dispensing systems are becoming standard infrastructure. Every minute a pharmacist spends checking and bagging is a minute they are not spending on consultation. Automation redirects their time to work only pharmacists can do.
2026–2027 Pharmacy Trend Summary
| Trend | Now (2026) | Next (2027) | Impact for Vor-Ort Pharmacies |
|---|---|---|---|
| E-Rezept & GesundheitsID | eGK + CardLink dominant. PoPP Stage 1 launches mid-2026. | CardLink ends Jan 2027. GesundheitsID + PoPP become standard. | Pharmacies must be PoPP-ready and integrated before CardLink shutdown. |
| ePA & eML | eML live since April 29, 2025. eMP pharmacy editing from March 2026. | eMP nationwide Q3 2026. ePA 3.0 adds automated checks. | Pharmacies able to edit the eMP gain a significant consultation differentiation. |
| AI in pharmacy | 13% of pharmacies using AI tools. EU AI Act rules apply Aug 2026. | Agentic AI (autonomous workflow) enters pharmacy software. | Early adopters gain efficiency in stock management and chatbot triage. |
| OTC mail-order competition | Top 4 online pharmacies hold 58.1% of volume. 12.8% channel growth. | OTC price pressure intensifies. Local pharmacies differentiate on service. | Digital service stack (app, delivery, chatbot) is the competitive response. |
| Pharmacy closures | 16,601 pharmacies left. 502 closures in 2025. | Structural decline continues. Survivors inherit patients. | Digital reach lets pharmacies serve a wider catchment area without new staff. |
| BtM digital prescriptions | BtM goes electronic for private patients (PKV) from Q2 2026. | Paper BtM forms eliminated for GKV and PKV. | Pharmacies need TI infrastructure capable of processing digital BtM. |
| Pharmacy automation | European market growing. Driven by staff shortages. | Serialisation mandates accelerate robotic dispensing. | Automated dispensing frees staff time for consultation. |
Which Pharmacies Will Thrive — and Which Are at Risk
| Pharmacies That Will Thrive | Pharmacies at Risk of Closing |
|---|---|
| Operate a pharmacy app for pre-ordering and communication | No digital patient touchpoint beyond phone and counter |
| Offer Click & Collect and Botendienst (home delivery) | Counter-only model with no delivery or pick-up option |
| Integrated with E-Rezept and ready for PoPP (July 2026) | Still relying on CardLink with no PoPP migration plan |
| Actively editing patient eMPs — visible consultation | Not using eMP editing capability — invisible vs. mail-order |
| Using AI chatbot for triage and repeat prescription queries | All patient contact handled manually — no after-hours presence |
| Strong local brand, SEO-visible, active on social channels | No online presence — not findable when patients search |
| Building a loyal patient base through digital engagement | Competing on price against mail-order — a structural disadvantage |
The German pharmacy sector is not dying — it is bifurcating. The structural decline in pharmacy numbers will continue, but the pharmacies with strong digital infrastructure and consultation-led patient relationships are growing their patient bases even as the total number of pharmacies falls. The window to build that infrastructure is now. Each of the trends above has a practical action attached to it:
- PoPP readiness: Confirm your pharmacy software's PoPP migration plan before July 2026. CardLink ends January 2027.
- eMP editing: Ensure your PVS supports eMP editing when the March 2026 launch arrives. Use it actively.
- AI chatbot: Evaluate pharmacy chatbot options for 2026. Prioritise platforms with clear EU AI Act Article 50 disclosure mechanisms.
- Digital patient touchpoint: A pharmacy app connected to Click & Collect, Botendienst, and E-Rezept is the single highest-leverage digital investment.
- Local SEO and visibility: Patients from closed nearby pharmacies will search online for a replacement. Be the search result they find.
Frequently Asked Questions
How many pharmacies are left in Germany?
At the end of 2025, there were 16,601 pharmacies in Germany — the lowest number in nearly 50 years. In 2025, 502 pharmacies closed and only 62 new ones opened.
What is the biggest threat to German pharmacies in 2026?
The combination of frozen compensation, rising operating costs (up 65% since 2013), and growing online competition. The pharmacies most at risk are those that haven't built a digital patient relationship.
What is PoPP and why does it matter for pharmacies?
PoPP (Proof of Patient Presence) is the replacement for CardLink. CardLink licences expire January 31, 2027. Pharmacies must ensure their software provider has a PoPP migration ready.
Will AI replace pharmacists in Germany?
No. §20 ApBetrO legally requires pharmaceutical consultation to be performed by a qualified pharmacist. AI handles the administrative and triage layer, freeing the pharmacist's time.
What is the eMP and when can pharmacists edit it?
The elektronischer Medikationsplan (eMP) is the patient's medication plan. From March 2026, pharmacists can edit it directly, documenting consultations and updating information visible to GPs.
Is digital transformation affordable for small pharmacies?
Yes. The most impactful digital tools — app, Click & Collect, Botendienst — are available as SaaS services at predictable monthly costs without heavy hardware investment (e.g., platforms like Mediloon).
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.