Pills + Politics

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But not if the German pharmacy lobby gets its way. "We'll take this as far as we have to," says Heinz-Günter Wolf, president of the Federation of German Pharmacies. Most likely a final decision in their court battle won't come from the European Court of Justice for years. The lobby scored a minor victory last month when a court upheld its request for an injunction forcing DocMorris to close its Saarbrücken pharmacy. But closure is unlikely, as both the state of Saarland and DocMorris have filed countersuits. "This is far from over," says Däinghaus. "We won't be forced to close."

Still, both sides agree that allowing big retail chains will put neighborhood pharmacies out of business. Will that hurt consumers? The pharmacy lobby says fewer pharmacies will result in poorer service for patients, which could be especially significant in sparsely populated rural areas. Although in the U.K., while the market share of retail chains has grown, the overall number of pharmacies has remained remarkably stable over the past few years — 12,482 today compared to 12,258 in 2000 — and they stay open for longer. Thus, the industry maintains that patient choice has improved, not suffered. A spokeswoman for abda, the German pharmacy lobby group, says that in countries where aspirin is sold over the counter, stomach illnesses related to aspirin abuse are more frequent. But to some, these sound simply like excuses to preserve high prices. Gerd Glaeske, an adviser to the German government on health policy, says "there are too many pharmacies in Germany."

Back in Saarbrücken, Fritz Trennheuser, 42, senses that trying to stop change is a losing battle. He sees the lines winding around DocMorris from the window of his depopulated store. If the laws are changed, he and other pharmacists are planning to join together and negotiate with drug companies for lower prices, just like DocMorris. "If politicians allow this to go on, then the same rules have to apply to everyone," he says glumly. The wave of change hitting him may lead to lower health-care costs for everyone. But like other pharmacists, he is finding it a bitter pill.