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Berlin – In the future, pharmacists will not only be able to vaccinate against COVID-19 and flu, but will also be allowed to carry out all other vaccinations with inactivated vaccines on adults on a permanent basis. This is provided for by amendments to the law to strengthen public health that have not yet been coordinated by departments German medical journal present.

In the future, pharmacies would also be able to offer vaccinations against diptheria, hepatitis B, polio, whooping cough and tetanus, among others. These changes were already included in the draft of the Pharmacy Reform Act. However, the adoption of the draft by the Federal Cabinet has repeatedly been delayed.

The content of the planned pharmacy reform law is highly controversial in the healthcare system. The FDP had also spoken out against essential reform content. It could therefore be that the traffic light government wants to transfer the plan to expand vaccinations in pharmacies into the law to strengthen public health so that the plans can come into force more quickly.

The prerequisite for the planned vaccination expansion is that the pharmacists have completed appropriate medical training and that these vaccinations are carried out for a public pharmacy where they work. Only people aged 18 and over are allowed to be vaccinated in the pharmacy.

Anyone who has already been medically trained to vaccinate in the pharmacy only needs additional training for further vaccination with inactivated vaccines. The aim is to convey knowledge of possible contraindications as well as skills and abilities for the respective vaccination.

The Federal Medical Association (BÄK) and the Federal Pharmacists’ Association (BAK) should further develop and expand the existing model curriculum for carrying out vaccinations in pharmacies, the amendments continue.

The previously existing age limit for vaccinations against COVID-19 from 12 years old is to be adjusted with these regulations. The background is that the current COVID-19 vaccination recommendation for people who have not yet reached the age of 18 is no longer standard. The Standing Vaccination Commission (STIKO) revised this in its recommendations last year.

The draft further clarifies that the vaccination of live vaccines should generally be reserved for doctors. These include vaccines such as measles, mumps, rubella and chickenpox.

Pharmacies and nursing staff should be allowed to test more

The amendments also stipulate that in the future, in-vitro diagnostics for rapid tests for adenoviruses, influenza viruses, norovirus, respiratory syncytial viruses and rotavirus can be carried out in pharmacies and by nursing staff in nursing homes. The aim is to prevent early outbreaks of disease by expanding the range of tests available. This is also already provided for in the draft of the Pharmacy Reform Act.

Until now, pharmacies were only allowed to test for COVID-19. In recent years, pharmacies have created a corresponding testing infrastructure nationwide, according to the amendments. “This test infrastructure that has been created should continue to be used flexibly and cost-effectively in the future.”

Pharmacy identification process planned

The changes also include a further application to establish a procedure by which those insured by statutory health insurance (GKV) can authenticate themselves when setting up an electronic patient file (ePA).

In the future, insured people should also be able to obtain a health ID from their health insurance company at the pharmacy. This is required to set up the ePA. The “ePA for all” is to be made available to all insured persons via an opt-out regulation from the beginning of 2025. Insured persons can object if they do not wish this.

The procedure in the pharmacy should work similarly to Post-Ident in Deutsche Post branches. Accordingly, insured persons should be able to identify themselves securely and be provided with a health ID or a PIN for the electronic health card (eGK). There is also a procedure in which insured persons can also go to the office of their health insurance company to authenticate themselves accordingly.

The commissioning of a company to technically enable the procedure in the pharmacy will now be regulated, according to the amendments. A quick, technical implementation and a close integration of the pharmacy identification process with the telematics infrastructure and the e-prescription application should be made possible.

According to the amendments, the pharmacy identification process includes two stages. The first stage includes the cash register-induced process and will be provided by the cash registers from the specified deadline. The second stage includes the insured-induced process and should be provided by the health insurance companies as soon as the necessary conditions have been created by the Telematics Society.

Those in need of care should be able to redeem e-prescriptions by telephone

Those in need of care should also be able to choose a favorite pharmacy in the future. Up to five pharmacies can be named. With this appointment, insured persons in need of care could redeem e-prescriptions without visiting the pharmacy.

Those in need of care can inform the pharmacy about existing e-prescriptions by telephone, email or via messenger and ask for the prescription to be redeemed, according to the amendments.

According to the applications, secure identification for designation as a favorite pharmacy is carried out either through the pharmacy identification process in the pharmacy, via an e-prescription app or via another secure identification process, such as the post-identification process.

The law to strengthen public health primarily provides for the establishment of a Federal Institute for Prevention and Education in Medicine (BIPAM). The institute is scheduled to begin work on January 1, 2025 and, as an independent higher federal authority, will take over the tasks of the Federal Center for Health Education (BZgA) and partly of the Robert Koch Institute (RKI).

The Bundestag discussed the law in its first reading at the end of September. An expert hearing on this bill is scheduled for tomorrow in the Health Committee. © cmk/aerzteblatt.de