BAld one year ago, Jens Spahn came to the lectern at the German Pharmacist's Day in Munich and told the assembled pharmacy about his idea. It was about the money; The pharmacists expected the new Federal Minister of Health to come up with suggestions on how to handle the competition from the Internet. They wanted to ban the hated mail order, but Spahn did not want to get involved. “Let's talk about other fee models, which are not tied only to the delivery of a drug package,” said the CDU politician. “I would imagine that being vaccinated in pharmacies.”
The pharmacists in the hall were amazed at this unexpected push. On the other hand, the German doctors responded in a generally angry manner – they took up the proposal as an attack on their profession, which was unsurprising. The tasks of the doctor and the pharmacist have always been strictly separated; administering a vaccine has always been considered a medical task.
Unlike many physicians had hoped, the topic did not go away by itself. On the contrary. Within a year, the vague idea of the minister has become a concrete plan. On Friday, the Bundestag debated in its first reading on the Ministry of Health initiated Measles Protection Act, which provides a duty to vaccine against measles in children and educators. In a subordinate sentence of her speech, the SPD politician Sabine Dittmar said that the grand coalition had agreed to an amendment. According to Dittmar, this will allow pharmacists to self-administer vaccines in the future – not against measles, which is what the law is all about, but against the flu. In the neighboring country of France, this is exactly what has been possible since the beginning of the month – even then, a model trial was preceded by nationwide regulation.
With the flu the vaccination quotas should be increased, demand Union and SPD. Finally, only one in ten could be vaccinated against the influenza virus in Germany; especially older people, who are strongly recommended as a risk group vaccination, are too rarely protected against a severe course of the flu. In addition, pregnant women and the chronically ill are recommended to vaccinate, whereas healthy adults are not.
The doctors have provided this consultation so far, now they should share the task with the pharmacists. The indignation of the physicians in private practice, who are also worried about a part of their remuneration, was not long in coming. One has for this project no understanding, informed the Kassenärztliche Vereinigung Westfalen-Lippe on Monday. The previous system works well, there is “no need at all” to change it. The head of the health insurance company AOK Rheinland / Hamburg, Günter Wältermann, sees it completely differently. He told the newspaper “Rheinische Post” that he would welcome pharmacists to vaccinate. Thus, the vaccination rate of the population can be increased, it could avoid many flu deaths.
As clear as the coalition's intention is to allow pharmacists to administer a flu vaccine, the barriers are manifold – as the Union and SPD amendment also makes clear. According to this, health insurance companies should conclude corresponding contracts with the pharmacies. If you want to vaccinate as a pharmacist, you must have separate rooms with a patient bed. However, the vaccinations should be limited to adult customers – in children, a vaccine is indicated only for the chronically ill, and with them, the doctor should remain responsible.
The professional code of pharmacists could become a problem
In addition, the reform will initially be limited to five years and will be scientifically monitored in order to find out whether vaccination rates could be increased as a result. Above all, however, pharmacists who want to vaccinate should first receive “medical training”, as stated in the application. They are to learn how to act – how to educate customers about risks, how to properly administer the injection and how to identify potential cases where vaccination would be medically risky. Above all, however, the training provides for the “knowledge of emergency measures in case of acute vaccination reactions”. This is aimed at the physicians' main argument to leave everything as it is: only they are qualified to look after a patient who reacts after a vaccination with a severe allergy. This happens very rarely, but it can happen.
That the project will be difficult to implement, the coalition itself knows. The application states that before the proposed reform, the professional code of the pharmacy chamber “if necessary” be changed. It states that pharmacists give medicines and advise on this. But: “The pharmacist may not practice medicine on humans and animals.”
(TagToTranslate) Jens Spahn (t) Sabine Dittmar (t) SPD (t) CDU (t) Bundestag (t) BMG (t) Backroom