Study: Pharmacies Often Only Accessible by Car
Germany's pharmacy crisis leaves 16 million without nearby access
Patients are facing ever-longer journeys—a common complaint when discussing the consequences of pharmacy closures. Typically, the issue is framed in terms of distance in kilometers, but what does that actually mean in practice? According to an accessibility analysis by the University of Giessen, reliable access to pharmaceutical care for a large portion of the population hinges on whether people have access to a car. Unlike post offices, there is no legal guarantee ensuring that every community has a pharmacy.
The steady decline in pharmacy numbers is no secret. While there were 20,441 pharmacy locations in 2014, that figure had dropped to 16,908 by early April 2025—and the trend continues downward. Pharmacists' associations and chambers have recently warned of worsening access to care, but health insurers dismiss these concerns as alarmist, citing two studies they claim prove that pharmacies remain within reasonable reach.
However, a study by Professor Georg Götz of the University of Giessen's Department of Economics, along with his colleagues Dr. Daniel Herold, Dr. Jan Thomas Schäfer, and Maximilian Maurice Gail, paints a different picture. While pharmacies are generally accessible by car or public transport, the distances involved can still be substantial. For those with limited mobility—whether due to age, disability, or financial constraints that prevent car ownership—this could mean being effectively cut off from essential medication.
The analysis finds that with a reasonable one-way travel time of 30 minutes, around 16 million people—19% of the population—cannot reach the nearest pharmacy on foot. Even if the travel time is extended to 60 minutes, roughly 6 million people, or 7% of the population, still lack walkable access.
One-Third of Population Struggles to Reach a Pharmacy
Contrary to a study by the Barmer health insurance fund, which suggests that over 73% of people live within 6 kilometers of a pharmacy, the Giessen researchers arrive at a starkly different conclusion: Approximately 27.7 million people—nearly one-third of the population—cannot reach the nearest pharmacy within a 30-minute walk. For these individuals, the closure of a local pharmacy could have serious consequences.
The situation is particularly dire for older adults, many of whom face mobility challenges. The study reveals that more than half of all people aged 75 and older already cannot reach the nearest pharmacy within a 10-minute walk. If current trends persist, the researchers warn, access to pharmaceutical care for a significant portion of the population could be at risk.
Post Offices Guaranteed—Pharmacies Not
The study's authors criticize policymakers for failing to establish clear targets for ensuring pharmaceutical access in their reforms. A comparison with another sector proves telling: Unlike pharmacies, post offices are subject to strict legal requirements under the German Postal Act (Postgesetz). The law mandates that every municipality with more than 2,000 residents must have at least one postal branch operated by a universal service provider. The analysis highlights that in states like Bavaria, Mecklenburg-Western Pomerania, Schleswig-Holstein, and Baden-Württemberg, numerous towns have post offices but no pharmacies. In fact, 911 municipalities with populations exceeding 2,000 lack a single pharmacy.
The researchers describe the current approach as "grossly negligent."
This paper stems from a research project financially supported by the Pharmacists' Association of Westphalia-Lippia (AVWL). Pharmacies remain essential around the clock, even in emergencies, the association stresses. In small communities—where the nearest doctor's office may be far away—local pharmacies are increasingly taking on broader healthcare roles, ensuring vital services stay available, explains AVWL president Thomas Rochell. "How can we talk about public welfare when the very people who depend on nearby pharmacies—those with limited mobility, for example—are the ones being left behind?"
Criticism also comes from Noweda, another project backer: "It's commendable that the state ensures postal services remain accessible in rural areas. But it's grossly negligent to have stood by while pharmacies have been disappearing at an alarming rate—without ever implementing lasting economic support measures," says CEO Dr. Michael Kuck.
