Fabrice Camaioni, President of the Federation of French Pharmaceutical Unions (FSPF), has said that the upcoming negotiations should not simply focus on securing an extra financial budget. Instead, the FSPF wants to rethink the entire system of how pharmacists are paid. The goal is to reduce the reliance on the number of prescriptions, better acknowledge the work of pharmacists, and protect the most vulnerable pharmacies from the impacts of reform. Camaioni stressed that starting with a fixed financial amount would be the wrong approach. He believes that first, the economic situation of pharmacies must be clearly understood, current imbalances identified, and suitable compensation mechanisms developed. Only after this analysis can the specific needs be determined and a remuneration system tailored to the diversity of the pharmacy network be created. Price reductions on medicines have been a major challenge for pharmacies. According to Camaioni, 1.1 billion euros in price cuts on non-generic medicines resulted in 39 million euros in losses for pharmacies in 2025. In contrast, price reductions on certain generic medicines had a much greater impact, with pharmacists losing at least 40% of that amount. Camaioni advocated for increasing the portion of remuneration based on honorariums, recognizing that analyzing prescriptions takes time unrelated to the number of prescriptions delivered. However, he acknowledged that moving more towards honorariums could negatively affect around 10% of pharmacies, particularly the smallest ones. To help these pharmacies, he suggested a fixed allowance or one tied to specific criteria to provide financial support. Camaioni argued that tasks beyond the usual dispensation of medicines, such as correcting prescription errors or pausing deliveries to consult a doctor, should be compensated. This would require integrating these tasks directly into pharmacy business software to track and value them appropriately. Camaioni also mentioned that the savings from substituting biological medicines with biosimilars, amounting to about 170 million euros for the Health Insurance Fund in the last year, should be taken into account. However, he emphasized that pharmacists should not be solely responsible for new duties without receiving proper recognition. Camaioni called for a reevaluation of how value is shared, particularly regarding the role of pharmacy groupings in the drug supply chain. While he acknowledged the usefulness of groupings, he stressed the need to document and, if necessary, better regulate the activities of intermediaries, as some may be capturing significant value. Camaioni warned that the reform could speed up the restructuring of the pharmacy network, leading to a continued decline in the number of pharmacies in certain areas. He supported groupings that involve significant investments to adapt premises and handle new responsibilities but opposed a compensation fund that would make some pharmacies permanently reliant on support. Camaioni emphasized the importance of preserving the independence of the pharmacy network, cautioning against the financialization of the health sector. He also highlighted the need to inform young pharmacists about available support structures and to ensure that agreements are properly reviewed by the relevant professional order. He noted that the current medical shortage reinforces the urgency of revising the economic model for pharmacies, as pharmacists should be economically recognized for taking on additional responsibilities. Even if medical demographics improve in the coming years, the issue of drug distribution will remain unresolved.