Kassenabschlag

Kassenabschlag is a discount the pharmacy does not choose. For every package dispensed on a prescription at the expense of the gesetzliche Krankenversicherung, a fixed amount per package is deducted from what the pharmacy is paid. The insurer takes it at settlement, there is nothing to negotiate, and it applies whether that particular prescription was worth dispensing or not.

Two features make it uncomfortable. It is charged per package rather than on turnover, so it falls hardest on high volume and low value dispensing. And it works directly against the Packungsfixum, because both are per-package amounts pointing in opposite directions. The Fixum rises from 8,35 to 9,00 euro on 1 July 2026 and to 9,50 euro on 1 January 2027, and any increase in the Kassenabschlag over the same period reduces that gain before it reaches the pharmacy.

One point deserves stating precisely, because it is often reported the other way round. The increase in the Kassenabschlag does not come from the ApoVWG. It rides on a separate piece of legislation on the financing side of the statutory system, and the two run through the process on their own timetables. Reading a summary of the Apothekenreform and treating it as having settled the Kassenabschlag question is a common error, and it produces plans that are confident about the wrong number. The amount itself also moves, so any figure quoted in a trade article is worth checking against the applicable law before it goes into a calculation.

For a pharmacy weighing up a new service, the relevance is structural rather than dramatic. The reimbursed side carries a per-package deduction the pharmacy cannot influence, and part of the improvement in the Fixum is absorbed by it. Revenue outside that mechanism behaves differently. A pharmazeutische Dienstleistung is paid from the pDL fund at a defined fee against a defined protocol, and a self-pay service is priced by the pharmacy and paid by the customer, with no per-item deduction applied to it. Neither of those replaces prescription business and neither makes the Kassenabschlag lighter, so neither should be modelled as though it did.

How the deduction appears in a specific monthly settlement, and how it is treated in the pharmacy's own accounts, follows from the Rechenzentrum statements and belongs with the Steuerberater rather than with a general rule stated here.