Fixum

The Fixum is the fixed component of the pharmacy surcharge on a prescription pack under § 3 Arzneimittelpreisverordnung, alongside a three percent surcharge on the Apothekeneinkaufspreis.

The increase did not come from the ApoVWG, which is the single most common error in coverage of the Apothekenreform. It came from the Dritte Verordnung zur Änderung der Arzneimittelpreisverordnung of 9 June 2026, published as Bundesgesetzblatt 2026 Teil I Nummer 173. That ordinance raised the Fixum from 8,35 Euro to 9,00 Euro on 1 July 2026 and raises it to 9,50 Euro on 1 January 2027, after the 8,35 Euro figure had been unchanged since 2013.

What the ApoVWG itself does is narrower. From 1 January 2027 it merges the 21 Cent Notdienst surcharge and the 20 Cent surcharge that financed pharmazeutische Dienstleistungen into a single 41 Cent Notdienst surcharge. The per-pack total is unchanged at that step, and the reform suspends that surcharge for an interim period.

Three things the reform does not do are worth knowing, because each of them circulates as though it did:

1. It introduces no Kombimodell for the pharmacy surcharge.
2. It leaves the three percent component exactly as it was.
3. It does not change the Apothekenabschlag either.

ABDA states that pharmacy operating costs are 65 percent higher than when the Fixum was last set, which is the context for the reform's emphasis on services rather than margin.