why pharmacies are changing

“No to pharmaceutical deserts!” On the window of this pharmacy in a town in the Monts du Lyonnais, in the Rhône, is displayed the petition launched by the two main pharmacists’ unions. In this town of 6,000 inhabitants, the appeal, which aims to alert patients to the risk of weakening pharmacies, has already collected more than 2,000 signatures (1).

What gives pharmacists so many pimples? A decree, published in Official Journal on August 4, 2025, which provided for reducing the ceiling from 40% to 30% of commercial discounts granted by laboratories to pharmacists. And even if the new Minister of Health, Stéphanie Rist, announced on November 4, 2025 the suspension of this decree until December 31, 2026, pharmacists have not all put their petitions at the bottom of their drawers. “The conflict revealed how fragile our economic model is,” explains Dr. Yorick Berger, spokesperson for the FSPF (2), the main pharmacists’ union.

This decree served as a reminder of the extent to which pharmacies remain dependent on the price of medicines. For ten years, public authorities have tried to diversify their income by creating fees to promote the act of dispensing treatments, but sales remain their main source of profitability. “This is based almost exclusively on the sale of medicines, which generates 80% of my income, as with my colleagues,” underlines Dr Mathieu Blayac, pharmacist in Lespignan, a rural town in the south of Hérault.

However, a significant part of this income comes from “discounts” granted by laboratories to pharmacists on the purchase price of medicines. It is the difference between this purchase price and the reimbursement made by Social Security which constitutes their margin. We therefore understand that the modification of the rate of these discounts has so agitated the 20,502 pharmacies listed on January 1, 2024. “I would have lost 10,000 euros to 20,000 euros net per year,” continues Mathieu Blayac.

Falling margins

For ten years, the fall in the price of medicines, combined with inflation and the scarcity of doctors – and therefore of prescriptions – has reduced the margins of pharmacies. Especially since some treatments, which are barely visible, are not paid for. “It is completely normal to take time to explain to a patient how to follow their treatment, treat a sore or make a pill box for an elderly person, but this generates costs which are not recognized,” testifies Dr. Isabelle Chopineau, pharmacist in Vailly-sur-Sauldre, a village of 650 inhabitants in Cher, president of the regional council of the Order of Pharmacists.

Since the Covid crisis, the role of the pharmacist has nevertheless expanded considerably: screenings, vaccinations, tests in cases of angina or cystitis, teleconsultations, etc. In 2023-2024, for the first time, flu vaccination was mainly carried out by pharmacists (59%, compared to 17% for nurses (3)).

Many pharmacies find themselves in a difficult situation. “We must put an end to the image of the well-off pharmacist driving in his convertible car!” Isabelle Chopineau protests, laughing. In ten years, France has lost more than 2,100 pharmacies (3). In 2024, 216 of them had to lower the curtain. And this rate is increasing, especially in rural areas (4). Zoning into “fragile territories” with financial support, created in 2024, turns out to be complex and ineffective.

New missions

The deadline granted by the Minister of Health should allow pharmacists’ unions to renegotiate the discount ceiling. But above all, it must be used to rethink the economic model of pharmacies. An interministerial mission has just been created for this purpose. Several avenues exist: in addition to increasing fee-for-service payments, pharmacies should offer first aid more widely and direct the patient to the most suitable caregiver.

An experiment in this direction, “Osys” (orientation in the healthcare system), started in Brittany in 2021, and occasionally extended to three other regions, could serve as a model. “Our quality as a “gateway” into the healthcare system must be recognized, in good harmony with other healthcare professionals,” wishes Yorick Berger, of the FSPF. It is therefore possible that in the medium term, you will be invited to first cross the threshold of your pharmacy, before waiting in the corridors of the hospital or at your doctor’s office.

225,000 signatures nationally on change.org
Federation of Pharmaceutical Unions of France.
Report from the Court of Auditors, May 2025.
Between 2015-2019 and 2019-2021, the average annual rate of closures almost quintupled in rural towns.