Germany is the biggest pharmacy market in Europe with €35 billion, or $46 billion, of revenue each year. In Germany, pharmacies are known as "Apotheken". Like France, they are all independently owned by pharmacists, and like France, there are no pharmacy chains. In hindsight to consumer protection, German law bans chains of Apotheken, but generally allows self-employed pharmacists to individually operate a maximum of four outlets, all of which must be in close proximity.
Other types of retailing are strongly opposed to offer the same types of services as an Apotheke. These retailers would not have the necessary expertise to provide proper patient care and this has been upheld by the European Court of Justice in its ruling of May 2009. Traditionally in Germany, drugs were not discountable and the entire trade with pharmaceuticals was limited to the single channel of the Apotheke. In 2004 however, the health care reform law GMG[disambiguation needed] allowed free pricing of OTC- products. This led to a significant decrease of OTC- prices in competitive areas. Internet and mail-order purchasing of drugs has also become an alternative, however it only accounts for about 5% of German pharmaceutical trade.
Online pharmacy DocMorris has been introducing the first, licence based chain pharmacy model in Germany in 2007 (as opposed to the current Independent pharmacy model). Alongside their brand, they are offering standardized services in their pharmacies, whilst they do not operate or own them. They also offer discounted OTC products. Besides this model, German pharmacies are for the most part organized in wholesaler- based cooperations like LINDA,[disambiguation needed]de [gesund leben-Apotheken], de [meine apotheke]orvivesco. These cooperations are offering discounts in purchasing and support e.g. in Marketing.
DocMorris CEORalf Däinghaus claims the German system to be monopolistic because government sets the profit margin that drug makers, wholesalers and pharmacists are allowed to make, resulting in strongly invariant price levels at all traditional outlets- even though most of the 21,500 pharmacies in the country are run independently. Traditional German pharmacists respond that a strategy of generally discounting pharmaceuticals may push people to use more drugs and would be against the general principles of health and customer protection.[3]
India's retail pharmacy sector is beginning to consolidate into a group of large players, many of them owned by larger health groups and/or franchised.[4]
Pharmacies in the Netherlands are mostly independently owned by pharmacists. In 2011, 31% of all pharmacies were part of one of the following chains:[6]
Sainsbury's – Hundreds of stores have in-store pharmacies, including consulting rooms. Sainsbury's is the first supermarket in the UK to start having GP's working in their pharmacies as part of smaller doctor surgeries.[10]
Although not a pharmacy chain, many of the fairly ubiquitous Costco stores include a pharmacy and - in California at least - the pharmacy is available to non-members. Their prices are likely to be among the lowest [citation needed]
Ranking
The table below shows the Top 25 Pharmacy chains in the United States per state ranked by the number of pharmacists per chain, according to the National Pharmacy Market Summary done by SK&A 2010.[11]
Top 25 Pharmacy chains ranked by the number of Pharmacists
