As of January 20, 2027, wholesale distributors will receive a minimum of 22 cents per box of reimbursable medication, down from 30 cents currently. This reduction has raised concerns about the financial stability of the sector. The CSRP (Committee for the Study of Pharmaceutical Distribution) estimates that the direct loss for the sector could reach 50 million euros, though it is still unclear what the full impact of this change will be on commercial negotiations with pharmaceutical laboratories, pharmacy groups, and other stakeholders. Arthur Arlaud, a prominent figure in the industry, argues that a more comprehensive reform is needed to better compensate for the services provided by wholesale distributors. Pharmacist unions have estimated that the impact of this margin reduction could be at least 100 million euros for pharmacies. While Arlaud has not commented on these figures, he has not contested them either. The CSRP has not yet confirmed or ruled out potential changes in the commercial conditions offered to pharmacies following this decrease in margins. The sector was already in deficit in 2025, and this new reduction may worsen the situation. Some expensive medications, when considering the financial commitments related to cash immobilization, insurance, and other associated costs, may also become unprofitable. The Igas-IGF report had previously highlighted a decline in the profitability of wholesale distributors. Arlaud believes that any changes to the remuneration of distribution should be part of a broader reform. However, the margin decrease was implemented without such a reform in place. According to Arlaud, the current compensation does not fully cover the cost of the service provided by wholesale distributors. With pressure on prices and a decrease in the volume of medication distributed, maintaining the same level of service quality is becoming increasingly difficult. He suggests that a specific remuneration for the service provided by these distributors—ensuring equitable, rapid, and reliable access to medications and medical devices, product safety, reliable supply, and controlled spending—should be recognized. Distribution currently accounts for about 1.8% of the price of medication, and the service rate reaches 99% when medications are available. Approximately 80% of medication flow passes through wholesale distributors, while only 20% goes through direct sales. For paracetamol, the situation is reversed, with about 80% of purchases being direct and only 20% going through wholesalers. Arlaud has criticized the 100% direct sales model, which pharmacist unions and the Order of Pharmacists have also opposed. Some medications that were previously reserved for hospitals are now being distributed in cities. The storage, traceability, and distribution of these medications can tie up large sums of money. The service provided to pharmacies and the health system has a cost that must be considered. The organization and frequency of deliveries are managed by individual companies within the framework of public service obligations. The closure of pharmacies can affect the cost of covering a territory, but there are no sector-specific indicators to precisely quantify these effects. Deliveries are already optimized, and companies are adapting to these challenges. Maintaining pharmaceutical coverage is crucial, as pharmacists remain the last health professionals easily accessible to the general public. However, access to healthcare is a growing concern for the French population. Therefore, both pharmacies and wholesale distributors must remain economically viable. Arlaud emphasizes that "There is no pharmacy without a wholesale distributor and there is no wholesale distributor without a pharmacy." Arlaud has asked the government to explain the decision behind the margin decrease and has expressed his disagreement with it. He is seeking a detailed discussion on the evolution of the system with the Ministry of Health and the Direction of Social Security (DSS). Initial exchanges with the DSS have begun, but they are still in the early stages. To date, based on the available information, the 2027 PLFSS (Program for the Law on Social Security Financing) does not include any new measures directly harmful to wholesale distributors. The main concern remains the regulation of pharmacy groups, the effects of which still need to be fully assessed across the entire distribution chain.