Regional Court Frankfurt a.M. (LG) on pharmacy selection in telemedicine platforms: No unlawful assignment – Judgment of 28.05.2025, Az. 2-06 O 150/25

Telemedicine, prescription forwarding and pharmacy law – How far does the prohibition on assignment under § 11 ApoG extend in the digital age?

Background: Dispute over prescription assignments and automated pharmacy selection

At the centre of the decision by the LG Frankfurt a.M. of 28 May 2025 lies a topical issue in pharmacy law: the legal admissibility of telemedicine platforms that issue digital prescriptions to patients and handle the supply of medicines directly through connected mail-order pharmacies – without the patient themselves selecting the pharmacy.

The applicant, an operator of its own telemedicine platform operating in Germany, saw this as a serious breach of competition law. Specifically, she objected to the cooperation of a Berlin pharmacist with the platform "S" (registered in London), which offers services in connection with medical cannabis in particular on the German market. In the so-called "Premium Delivery Service", following an online doctor's visit, not only was the prescription issued to the patient, but a mail-order pharmacy was also automatically selected – usually without the patient previously knowing which pharmacy would supply them.

Following test orders by the applicant, she received the medicine – such as medical cannabis – sent by the respondent (a Berlin pharmacist). The billing was carried out exclusively via platform "S". Invoices were sometimes refused or, on request, were only issued via the platform. The applicant regarded this as unlawful collusion within the meaning of § 11 Abs. 1 ApoG and sued the pharmacist in competition law for an injunction.

The legal dispute: violation of § 11 ApoG through automated pharmacy assignment?

The core issue of the proceedings was whether the business model of platform "S" – in particular the premium service with automatic pharmacy selection – violates the pharmacy law prohibition on assignment (§ 11 Abs. 1 ApoG) and whether the participating pharmacist is liable as a participant in such a prohibited agreement.

The applicant argued:

• Platform "S" decides which pharmacy will supply a prescription without involving the patient.
• The so-called free choice of pharmacy (§ 31 Abs. 1 SGB V) was thereby factually circumvented.
• The pharmacist is a participant in systematic, economically motivated prescription steering and is thus addressee of the prohibition on assignment.
• An agreement exists already because regular supplies between platform and pharmacy occur without prior contact with the patient – with payment made directly via the platform.

The pharmacist defended himself by pointing out that the patient must actively choose the "Premium Service" option. There is therefore no external determination, but a conscious decision. Furthermore, there is no contractual binding or collusive agreement with platform "S".

The decision of the LG Frankfurt: no unlawful assignment – no liability of the pharmacist

1. No violation of § 11 Abs. 1 ApoG

The LG Frankfurt denies a violation of the pharmacy law prohibition on assignment:

• The pharmacist is undisputedly the addressee of the provision (§ 11 ApoG) and is engaged in a specific competitive relationship with the applicant.
• There is also a certain involvement of the pharmacist in the operations of platform "S".
• However: the assignment of the prescription to a pharmacy occurs only within the scope of a service model consciously chosen by the patient ("Premium Service").

The patient makes an autonomous decision through this choice to entrust the platform with the pharmacy selection. This delegation is permissible – as the BGH in the judgment "Partnervertrag" clarified.

2. No factual coercion to use the Premium Service

Although the user guidance on platform "S" is designed to a certain extent to highlight the premium service, the alternative option "Prescription only (Standard Service)" is clearly offered to the patient already in the ordering process – including the option to select a pharmacy.

A violation of § 11 ApoG only occurs if the patient is actually deprived of the possibility of choosing a pharmacy. This is not the case here – freedom of choice is not concealed or systematically undermined.

3. No unlawful agreement between pharmacist and platform

A (tacit) agreement within the meaning of § 11 ApoG between the pharmacist and the platform could also not be established:

• The defendant plausibly demonstrated that he himself issues invoices and has no knowledge of any billing practices or "service fees" from "S".
• The plaintiff provided no concrete evidence of a contractual or factual binding that goes beyond mere supply on order.

Accordingly, there is also a lack of deliberate participation or a joint plan relevant to competition law.

Assessment and recommendations for action

What does the judgment mean for pharmacies and platform operators?

Telemedical cooperation models are legally permissible provided they preserve the patient's free choice of pharmacy.

Automatic pharmacy assignment is only permissible if the patient has consciously chosen it – for example by activating an optional service offering such as here.

A disadvantaging of freedom of pharmacy choice can result from technical design, pre-set options or intransparent user guidance. Platforms and pharmacists must therefore pay particular attention to discrimination-free user guidance.

Recommendation for pharmacies:

• Cooperations with platforms only after legal review – in particular with regard to selection mechanisms and contract contents.
• Technical review of ordering and processing procedures for possible factual impairments to freedom of choice.
• Documentation and transparency towards patients – for example through clearly identifiable sender information, comprehensible invoicing and reference to available options.

We support pharmacies in the legally secure design of cooperations with digital platforms – from contract review to technical user guidance in the ordering process.

Questions about the prohibition on assignment or cooperations with telemedicine platforms?
AVANTCORE Attorneys at Law in Stuttgart specialises in Pharmacy law and competition law in the healthcare sector specialised. Contact us for a well-founded assessment!