Introduction:The pharmacy sector is undergoing significant digital transformation, especially in the European Union with Germany at the forefront through its Digital Healthcare Act (DVG). While technological advancements promise improved healthcare delivery, they simultaneously threaten the stability of local pharmaceutical supply structures, particularly in rural areas. This study examines how digitalization impacts public health equity and the resilience of pharmacy services across diverse geographical settings. Methods: This systematic review followed PRISMA guidelines. Peer-reviewed articles, government reports, and policy documents published between 2018-2023 were identified through comprehensive searches of PubMed, Scopus, Web of Science, and Google Scholar. Inclusion criteria focused on digital pharmacy transformations in the EU (particularly Germany), public health implications, and supply chain stability. A narrative synthesis approach was employed to analyze the heterogeneous data. Results: Key digital advancements identified include e-prescriptions, online pharmacies, telepharmacy, and AI-driven systems. While these technologies have improved efficiency and access in urban areas, rural regions face implementation challenges due to inadequate digital infrastructure. The review identified regulatory fragmentation across the EU, persistent digital infrastructure gaps, and cybersecurity vulnerabilities as primary barriers to equitable digital transformation. Additionally, approximately 500 rural German pharmacies closed between 2020-2023, highlighting threats to local supply stability. Discussion: Our Digital pharmacy transformation offers significant potential benefits but requires coordinated intervention to ensure equitable implementation. Recommendations include harmonizing EU-wide regulations, investing strategically in rural digital infrastructure, strengthening cybersecurity measures, supporting local pharmacy models through financial incentives, and updating healthcare curricula to include digital competencies. These measures are essential to harness digital innovation while preserving equitable access to pharmaceutical care and maintaining the stability of vital local supply structures. Take-home message: While digital transformation of pharmacy systems offers significant efficiency and accessibility benefits, it simultaneously threatens local supply structures, particularly in rural areas with limited digital infrastructure. The closure of approximately 500 rural German pharmacies between 2020-2023 underscores the urgent need for balanced regulatory approaches that protect community access while embracing innovation. Addressing this challenge requires harmonized EU regulations, targeted infrastructure investments in underserved regions, and financial support for local pharmacies adapting to digital transformation.
Impact Factor
2022: 6.012
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