Friday, February 6, 2026

Statutory health insurance drug spending increases by 4.9% in 2025 – pharmacies do not benefit from rising costs

Spending by Germany’s statutory health insurance (GKV) on prescription medicines excluding vaccines increased significantly in 2025, as expected. According to current calculations by the German Pharmacists’ Association (DAV), total drug expenditure reached €56.4 billion including VAT, representing an increase of 4.9 percent compared to the previous year.

This means that actual spending aligns precisely with the forecast set out for 2025 by the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) in cooperation with the National Association of Statutory Health Insurance Physicians (KBV). The calculations are based on billing data from pharmacy clearing centers.

While overall drug expenditure is rising, pharmacy remuneration tells a different story. Remuneration has largely stagnated, despite pharmacies continuing to play a central role in ensuring access to medicines. At the beginning of 2025, income was initially reduced by an increased mandatory rebate in favor of statutory health insurers. In addition, the number of dispensed prescription medicines relevant for remuneration declined by 1.5 percent over the year to around 749 million packs.

Only the smaller, percentage-based component of pharmacy remuneration prevented an overall decline in total compensation. A final calculation of pharmacy remuneration for 2025 is not yet available; in 2024, it amounted to €5.84 billion.

“The figures for 2025 show very clearly: health insurance funds are spending more money on fewer medicines,” says Dr. Hans-Peter Hubmann, Chairman of the DAV. This development is largely driven by the increasing use of new and innovative medicines, which are often significantly more expensive than their predecessors. Through appropriate prescribing, physicians enable patients to benefit from medical progress – a development Hubmann describes as positive.

However, he strongly criticizes the economic situation of pharmacies. “Pharmacies are not benefiting from progress and growth – instead, they are being squeezed financially.” Since 2013, one in five pharmacies in Germany has had to close, while operating costs have risen by around 65 percent. During this period, the fixed remuneration of €8.35 per pack has remained unchanged. Although the coalition agreement includes a commitment to raise this fee to €9.50, there has been no progress in the current legislative process.

The DAV is therefore calling on the Bundestag, the Federal Government and the Bundesrat to strengthen the financial basis of pharmacies. The aim is to safeguard patient-oriented, local pharmaceutical care and to prevent access to pharmacies from becoming even more difficult for the population.