Shared medication review: the pharmacist's new role in 2026

The French Shared Medication Review (BPM) is not new — it has existed since 2018 — but its ramp-up in 2025-2026 changes the game. The pharmaceutical agreement signed in March 2022 broadened eligibility criteria (polymedicated patients aged 65 and over, vs 75 previously) and revalued the act. A complete BPM is now reimbursed €60 by the CPAM, with annual follow-up at €30. For an average pharmacy, that's €8,000 to €15,000 of new annual revenue — provided you have the organization to deliver it.

BPM in practice: what the regulation requires

The review happens in three stages. First, the initial interview with the patient: exhaustive review of treatments (with prescriptions, self-medication, supplements), identification of risks (interactions, redundancies, inappropriate dosages). Then, the formalized pharmaceutical analysis: conclusion note sent to the main prescriber with recommendations. Finally, the conclusion interview with the patient to re-explain the treatment.

Documents required for CPAM control are precise: signed report, dated letter to the GP, structured intake plan, and — since integration with Mon Espace Santé — uploading the report to the patient's DMP. Without these, the act is unpaid; worse, in case of audit, it can lead to a clawback (refund to CPAM).

Why 70% of pharmacies don't (or badly) do BPM

Identifying eligible patients

The pharmacy management software (LGO) doesn't offer a native filter "patients ≥65, ≥5 chronic medications, no BPM in the last 12 months". The pharmacist sorts manually, which discourages. Pharmacies that have structured BPM all have, without exception, a separate Excel file, updated Saturday evening.

Clinical time vs counter time

A BPM lasts 30 to 45 minutes. During those 45 minutes, the pharmacist must be quiet, which assumes a dedicated room (often the back office) and protection against interruptions. Many pharmacies got it and created an appointment schedule; but that schedule lives outside the LGO, in Doctolib or Calendly, with no link to the patient record.

Uploading to Mon Espace Santé remains craft work

Since 2024, the BPM report must be uploaded to the patient DMP. In practice, this means generating a structured PDF/A, signed by the pharmacist (CPS card), and sending it via DMP-API or via MS Santé to the GP. Most LGOs only offer raw PDF export, leaving the pharmacist to deposit it manually — which discourages regular practice.

The 2027 horizon: BPM expands

Three evolutions are expected. First, extension to patients on oral chemo (HAS proposal, awaiting CPAM arbitration): a population at very high iatrogenic risk where BPM would have direct clinical impact. Second, articulation with VKA and DOAC interviews: pharmacists already doing these can append a BPM at low marginal cost. Third, generalization of prevention reviews in pharmacies, which rests on the same mechanics of appointments, traceability and DMP upload.

For an owner-pharmacist thinking 2027-2028, the topic is no longer "do I do BPMs" — it's "how do I structure a pharmacy where 30-50 BPMs per month are routine, not a Saturday hero act".