Community pharmacies are approaching 2026 at a pivotal moment. Amid persistent uncertainties about profitability, announced price cuts, and growing ambitions for community healthcare, the community pharmacy model is set to undergo a profound transformation. Laurence Bouton, an independent senior consultant and expert on the French pharmaceutical landscape, provides an analysis of the network’s vulnerabilities, the levers that must be activated to preserve its regional coverage, and the essential conditions for establishing a compensation structure consistent with the healthcare role that society now expects of pharmacists.

 

Agnes Jacobs: After a summer marked by tensions and protests, the fall has begun with a mixed picture for community pharmacies. The year 2026 promises uncertainty, but also progress and opportunities. What are your predictions and hopes for community pharmacies in 2026?

Laurence Bouton: By 2026, I truly hope that pharmacists’ compensation will be thoroughly overhauled, rather than addressed through piecemeal measures. This is so that the sources of tension—particularly economic ones—that we saw in 2025 are truly resolved. Even though the Social Security Finance Act, enacted on December 31, provides assurances regarding generics and biosimilars, uncertainties remain regarding the pharmacy sector’s economic outlook, particularly with the escalation of price cuts (1.4 billion expected in 2026).

My hope, therefore, is that there will be a review of compensation that benefits all stakeholders. There is clearly a deficit in the Social Security system, which requires all healthcare stakeholders to make an effort. There is also a need for pharmacists to transition from being mere dispensers of healthcare products to becoming community healthcare providers—and, in particular, primary care providers.

Today, the healthcare network in France is inadequate. I would like to see a balanced approach that allows all pharmacists, regardless of their circumstances, to provide the services we expect them to deliver and to play an active role in the France Santé structures established by the 2026 Health Act.

 

AJ: Most of the concerns raised by pharmacists relate to pharmacy profitability and the sustainability of the pharmacy network, given that pharmacists remain the healthcare professionals closest to patients. What steps should be taken to ensure the network’s sustainability and preserve access to care? How can pharmacy groups support the profitability of pharmacies?

LB: A pharmacy’s profitability comes from two sources: providing healthcare services to patients—I no longer want to use the term “dispensing,” as it now goes far beyond that (vaccinations, prevention, screening, etc.)—and negotiating with suppliers for the products and services the pharmacist needs to ensure the quality of their work.

Today, there are shifts in focus. Take the example of generic drugs: the government needs pharmacists to promote the use of generics and biosimilars, but it compensates for this work almost exclusively through ROSP, which are bonuses tied to health outcomes. These are bonuses, not traditional compensation for pharmacists. If a task is assigned, before discussing bonuses, there must be compensation for that task.

When generic drugs were introduced 20 years ago, the government could not afford them and relied on pharmaceutical companies to cover most of the cost. Today, however, the government is also asking these companies to lower their prices. They cannot meet demands on both fronts. We therefore need to rethink how to restore balance, and why not discuss sharing the profits generated—yes, to save the healthcare system money, but not at the expense of the pharmacist’s economic well-being.

 

AJ: Smaller pharmacies, particularly those in rural areas, appear to be particularly vulnerable.

LB: Of course. In a village with only one doctor, the pharmacy can’t be as big as one in a shopping mall. Operating costs, however, aren’t proportional to size. When the doctor retires, the first problem is the lack of prescriptions, and patients end up seeing a doctor in the neighboring district. Business, which was already struggling, takes a nosedive.

This is true for rural pharmacies, but also for neighborhood pharmacies. In a local store, customers walk there. When there are no longer any doctors nearby, patients change their habits and may go to a pharmacy in a shopping mall. These pharmacies are thriving because of this shift in patient traffic.

It’s a vicious cycle: small pharmacies, with fewer resources, can no longer invest in their stock of over-the-counter products, fail to meet patients’ needs, and patients eventually stop going to their local pharmacy. So when patients really need them—especially as they get older—it’s too late; the pharmacy will have closed its doors.

 

AJ: What do you think of pharmacy branches? Can they help address some of these issues?

LB: Yes, that’s certainly true. It’s clear that the government doesn’t have the resources to match its ambitions. The goal is to establish an adequate pharmaceutical network in an environment where the medical infrastructure is already severely deteriorated.

The branch would allow costs to be shared with a pharmacy that can afford it. This is similar to post offices, which have been replaced by branches with reduced hours but the same level of service. It is better to have a pharmacy service that is economically viable for pharmacists and the healthcare system, in order to provide care to patients.

 

LB: In conclusion: we need healthy healthcare providers to promote good health. Pharmacists are healthcare providers and key players in the healthcare system. For them, mental health is essential, but financial well-being is just as important, and the two are closely linked.

I really want to reevaluate pharmacists’ compensation in light of the healthcare strategy we aim to develop in France, while taking into account the economic constraints of the pharmacy network. Right now, I feel like we’re cutting out entire segments of the pharmacy sector and merely sprinkling a little seasoning on the new responsibilities.

 

AJ: Finally, why should pharmacists attend PharmagoraPlus 2026?

LB: To develop a sound strategy, you need a clear vision. Of course, you can stay informed through the media, but PharmagoraPlus provides an overview of the current state of the pharmaceutical market, featuring expert speakers. It’s an opportunity to gain real-time insights, ask questions about topics that matter to them, and position themselves to define their strategy.

And when it comes to pharmacists’ mental health, it’s important to come together and share our concerns. To ensure pharmacists are healthy, we need both good mental health and financial stability. PharmagoraPlus listens to pharmacists and offers solutions that work for them: it’s definitely worth the trip.