Firm Guides · Pharmacies

Pharmacies in Italy: accounting, tax, employment and business rules

Pharmacy owners do two jobs at once. They run a business, with thousands of product lines, employees, banks and suppliers. They are also answerable for a healthcare service: the pharmacy’s location is assigned by an administrative act, opening hours and duty rotas are set by the Comune (municipality) and the local health authority, and a large part of the takings comes from the national health service, on the health authority’s timetable rather than the pharmacy’s.

Problems almost always arise where these two roles meet: the sale that remains in suspense until the Comune recognises it, the shareholder who works behind the counter and does not know which pension fund to pay into, the night on duty that the courts treat as working time, expired stock disposed of without paperwork that becomes revenue in a tax audit, the children who, after a bereavement, have only a few months to decide what happens to their parents’ pharmacy.

This guide is written for owners, directors and administrative staff, for those about to buy a pharmacy, for heirs and for fellow accountants who keep pharmacy accounts. It also covers the issues that textbooks overlook but that make the difference in a tax audit, an employment dispute or an estate.

The text is up to date as at 16 October 2026. For regional rules the reference is Emilia-Romagna, with some mention of Lombardy. One caveat applies to the whole guide: from 1 January 2027 the new consolidated tax Acts (testi unici) apply. They are the consolidated VAT Act (Legislative Decree No. 10 of 19 January 2026), the consolidated income tax Act (Legislative Decree No. 117 of 19 June 2026), the consolidated Act on registration tax and other indirect taxes, including inheritance and gift tax (Legislative Decree 123/2025), and the consolidated Act on tax penalties (Legislative Decree 173/2024). These are consolidating Acts: they change the numbering of the articles, not the substance of the rules examined here. Until 31 December 2026 Presidential Decree 633/1972, the TUIR (the 1986 consolidated income tax Act, Presidential Decree 917/1986), Presidential Decree 131/1986, Legislative Decree 346/1990 and Legislative Decrees 471 and 472 of 1997 remain in force, and these are the texts we refer to.

Ownership and the rules of the activity

A business within a planned service

A pharmacy cannot be opened wherever it would pay: it is one point in a service distributed across the territory, and the rules are still largely found in the consolidated Act on health laws (Royal Decree No. 1265 of 27 July 1934), Law No. 475 of 2 April 1968 and Law No. 362 of 8 November 1991, as amended by Decree-Law No. 1 of 24 January 2012 (Article 11) and by the annual competition law, Law No. 124 of 4 August 2017. The regions organise the service: in Emilia-Romagna the reference rule is L.R. (regional law) No. 2 of 3 March 2016, amended several times; in Lombardy the subject is covered by the regional consolidated health Act, L.R. No. 33 of 30 December 2009.

The number of pharmacies is capped. Article 1 of Law 475/1968, as worded by Decree-Law 1/2012, provides for one pharmacy for every 3,300 inhabitants; any remaining population gives entitlement to a further pharmacy only if it exceeds 50% of that ratio. Each new pharmacy must be at least 200 metres from the others, measured along the shortest pedestrian route between their entrances. Article 1-bis allows the regions to establish additional pharmacies, up to 5% of the total, in railway stations, airports, motorway service areas and large shopping centres; in Emilia-Romagna this was implemented by regional executive resolution No. 857 of 16 June 2017.

The pianta organica and its review

The pianta organica (the municipal plan that fixes the number of pharmacies and the area served by each) identifies the sedi (the licensed pharmacy areas) in the Comune and the zone of each. Since 2012 it has been the responsibility of the Comune, after consulting the local health authority and the Order of Pharmacists, and it is reviewed in even-numbered years on the basis of ISTAT (National Institute of Statistics) data (Article 2 of Law 475/1968). In Emilia-Romagna the procedure is laid down in Article 4 of L.R. 2/2016: the Comune starts it by February of the even year, consults the Order, sends the draft to the Azienda USL (local health authority) by 30 June, the health authority has ninety days to review it and the procedure ends by December with publication in the Regional Official Bulletin.

For those who already own a pharmacy the review is not mere red tape: redrawing the boundaries of an area or creating a new one shifts the catchment on which the value of the business depends. The resolution can be challenged before the TAR (regional administrative court) within sixty days of publication, but the most effective defence is to take part in the procedure between February and June, with documented observations on population, roads and existing services.

There is also a route in the opposite direction. Article 2(2-bis) of Law 475/1968, introduced by Law 124/2017, allows the owner of a pharmacy that has become surplus because of population decline, in a Comune with fewer than 6,600 inhabitants, to apply for transfer to another Comune in the same region where the number of pharmacies allowed exceeds those open, paying a one-off concession fee of €5,000. In Emilia-Romagna the areas that become available after each review are first offered through this procedure and, if that fails, through the ordinary regional competition (Article 6 of L.R. 2/2016).

Competitions, the Comune’s right of pre-emption and municipal pharmacies

The Comune may take ownership of half of the vacant or newly created areas (Article 9 of Law 475/1968), but not of those put out to the extraordinary competition under Decree-Law 1/2012. In Emilia-Romagna a Comune that exercises its right of pre-emption must open within one year of the approval of the pianta organica, otherwise it loses the right and the area goes to competition (Article 5 of L.R. 2/2016).

The 2012 extraordinary competition was reserved for individuals, who could also apply jointly by combining their qualifications; ownership obtained jointly is conditional on the joint management being maintained for three years (Article 11(7) of Decree-Law 1/2012). The Plenary Session of the Council of State (Adunanza plenaria, 17 January 2020, No. 1) laid down the rule that the options are alternatives: an applicant cannot obtain two areas and must choose one. Anyone buying shares in a company formed after the competition should read the award decree, check the opening date and look at the history of the shareholder base.

Municipal pharmacies are less well-trodden ground. The Comune may run them directly, through a special municipal agency, a consortium or a limited company (Article 9 of Law 475/1968), but the administrative courts hold that this list is not exhaustive and allow management to be granted to third parties by concession following a tender, with ownership remaining with the Comune (Council of State, Section III, 13 November 2014, No. 5587). The Comune may also transfer ownership: the employees have a right of pre-emption and the Comune loses its right of pre-emption on new areas for three years (Article 12 of Law 362/1991). Anyone taking part in a tender for management should read the tender notice with possible litigation in mind (term, goodwill on expiry, staff, fee, premises). A private party that has managed a municipal pharmacy for years, even as a shareholder in a mixed public-private company, does not acquire any right to the area for that reason alone.

Who may own a pharmacy

Today private pharmacies may be owned by individuals, partnerships, limited companies and limited liability cooperatives (Article 7(1) of Law 362/1991, as worded by Article 1(157) of Law 124/2017). The company’s sole object must be running the pharmacy, and since 2017 shareholders no longer need to be pharmacists. An individual who acquires a pharmacy by transfer, on the other hand, must be a pharmacist on the professional register who has qualified in a previous competition or has at least two years of certified professional practice (Article 12 of Law 475/1968).

Ownership may be transferred three years after it was obtained; the transfer must include the business itself, on pain of forfeiture (Article 12(11)), and must be recognised by the relevant authority, which in Emilia-Romagna is the Comune (Article 10 of L.R. 2/2016). That recognition is not a formality: it is a statutory condition precedent of the contract, with the consequences for employees that we examine in the chapter on employment.

The concentration limit is set by Article 1(158) of Law 124/2017: owners may control, directly or indirectly within the meaning of Articles 2359 et seq. of the Civil Code, no more than 20% of the pharmacies in the same region or autonomous province. It is a limit for each group, not an overall cap on investor-owned pharmacies, and it is enforced by the Italian Competition Authority using its powers under Law 287/1990 (paragraph 159).

Shareholders, incompatibilities and the director

Holding shares in a company that owns a pharmacy is incompatible with any activity in the manufacture of medicines or in scientific information on medicines, and with practising as a doctor (Article 7(2)). Article 8 adds incompatibility with being the owner, provisional manager, director or employed pharmacist of another pharmacy and with any public or private employment relationship. On this last wording, written for companies made up only of pharmacists, the Constitutional Court (judgment No. 11 of 5 February 2020) clarified by way of interpretation that it concerns shareholders who take part in managing the company or the pharmacy, not those who merely contribute capital. A pharmacist shareholder who works in the pharmacy, by contrast, falls squarely within it and cannot also be an employee of his or her own company.

By contrast, the Plenary Session of the Council of State (14 April 2022, No. 5) extended the incompatibility with the medical profession to legal persons as well: a private clinic that controls a company owning a pharmacy is incompatible, and control within the meaning of Article 2359 of the Civil Code creates a presumption of participation in management. In transactions involving funds, chains or healthcare groups the check must be carried out by tracing the entire chain of shareholdings.

The articles of association and every change, including changes in the shareholder base, must be notified within sixty days to FOFI (Federation of the Orders of Italian Pharmacists), the regional health department, the provincial Order and the local health authority (Article 8(2)). A breach of the rules in Articles 7 and 8 entails suspension of the pharmacist from the register for at least one year and, if all the shareholders are suspended, interruption of the management (Article 8(3)). In other words, an incompatible buyer of shares puts the company at risk, not just himself or herself.

A company-owned pharmacy is run by a qualified pharmacist acting as director (direttore, the pharmacist professionally responsible for the pharmacy), who is answerable for it (Article 7(3)) and who since 2017 need not be a shareholder; if the director becomes unable to act, the company replaces him or her temporarily with another qualified pharmacist (paragraph 4). The director is personally responsible for dispensing, registers, premises and prescriptions: a contract that leaves the director no real authority over professional work is weak from an administrative point of view and in terms of liability, including criminal liability.

Death of the owner or of a shareholder: the time limits for heirs

This is the moment when the family has the least time and energy, and when the legislation helps least. Article 12(12) of Law 475/1968 still states that the heirs may transfer ownership to a qualified pharmacist ‘within one year’, continuing to run the pharmacy provisionally in the meantime under the responsibility of a director. However, Article 7 of Law 362/1991, which is more recent, gives the heir of a shareholder who does not meet the requirements six months from the filing of the inheritance tax return (paragraph 9) and expressly extends it ‘also to the sale of the private pharmacy by the successors’ under Article 12(12) (paragraph 10). The special and later rule prevails: for the heirs of a sole owner the time limit is six months, and it runs from the filing of the inheritance tax return, not from the death. If the time limits expire without shareholders or successors, management is reassigned under the procedures in Article 4 (Article 7(11)).

Since Law 124/2017 an heir who is not a pharmacist has an alternative to selling: provided he or she does not practise as a doctor and does not work in the manufacture of medicines or in scientific information on medicines, he or she may be a shareholder in a company that owns a pharmacy. According to the interpretation of FOFI and the practice of several regions, the heirs of a sole owner may therefore form a company within the same time limit and keep the pharmacy, entrusting its direction to a pharmacist. This solution must first be checked with the Comune, but it often saves both the business and the exemption from inheritance tax.

If a company is left with only one shareholder, the remaining shareholder may bring in new ones within the mandatory time limit of six months (Article 7(12)). Pharmacies are also lost when nobody takes charge of the deadlines in the first months after a bereavement: regional decisions repeatedly feature the pharmacy left closed after the death of the owner or the director, with no new director and no sale under way, ending in forfeiture (Article 113 of the consolidated Act on health laws). In a family pharmacy, articles of association with approval and buy-out clauses, and the timely choice of a director, should be settled with a clear head, when nobody needs them: it is the most practical way of protecting those who will come after.

Relocation of premises and moving to a new residential area

A pharmacy may move only within its own area, to premises at least 200 metres from the other pharmacies, and the application is published for fifteen days on the notice boards of the local health authority and the Comune (Article 1 of Law 475/1968). In Emilia-Romagna authorisation is given by the Comune (Article 10 of L.R. 2/2016) and the application goes through the SUAP (one-stop shop for businesses). Relocation is the moment when cross-appeals between neighbouring pharmacies most often arise: measurement of the distance, stated entrance and actual entrance, area boundaries. Before signing a preliminary lease agreement it is advisable to have the pedestrian route and the floor plan checked and to make the contract conditional on authorisation.

Decentramento, that is, moving to a newly developed residential zone of the same Comune, is provided for by Article 5 of Law 362/1991; in Emilia-Romagna it is ordered by the Comune, which must set selection criteria if there is more than one applicant (Article 10 of L.R. 2/2016).

Rural pharmacies, dispensaries and branches

Rural pharmacies receive a residence allowance according to the criteria in Article 2 of Law No. 221 of 8 March 1968, linked to the population of the locality and to the disadvantages of the location; in Emilia-Romagna it is paid by the Azienda USL. Where the population has difficulty obtaining medicines the Comune may set up dispensaries (dispensari), entrusted to the nearest pharmacy, and in tourist resorts seasonal dispensaries or branches (Articles 8 and 9 of L.R. 2/2016). For a pharmacy in the Po Delta or the Apennines the dispensary is often more a service to the community than a profitable activity, but giving it up without assessing the effect on subsequent reviews of the pianta organica is a mistake.

Opening hours, duty rotas and holidays in Emilia-Romagna

Since Decree-Law 1/2012 mandatory opening hours and duty rotas are a minimum and do not prevent pharmacies from opening for longer (Article 11(8)). In Emilia-Romagna Article 13 of L.R. 2/2016 sets minimum weekday daytime opening of thirty-six hours a week; the Comune sets the minimum daily hours and the Azienda USL the daytime, night and public holiday duty rotas, after consulting the Comuni, the Order and the trade associations. Additional opening is unrestricted, subject to notification to the Comune and notice to the public.

In urban pharmacies duty is carried out with the doors open. The Comune may allow night duty with the doors closed, with a pharmacist present on the premises or in the same building, or duty on telephone call, with an immediate answer and delivery within thirty minutes of the call; rural pharmacies may carry out duty with the doors closed. The rotas must show the telephone number of the pharmacist on call, must be displayed outside and published on the Azienda USL’s website. The green cross is mandatory and outside urban areas it must be illuminated and kept lit at night. For staff, duty with the doors closed with the pharmacist in the building and on-call availability from home have very different consequences, as we shall see.

Holidays may be up to thirty days a year, in periods of not less than one week, in accordance with arrangements that the Azienda USL sets by 31 March (Article 14). In Lombardy duty rotas and holidays are decided by the ATS (health protection agencies) under L.R. 33/2009, with calendars and deadlines specific to each agency: those with pharmacies in more than one area must keep separate schedules.

The pharmacy of services after Law 182/2025

Legislative Decree No. 153 of 3 October 2009 defined the services that pharmacies provide within the national health service. Law No. 182 of 2 December 2025 (Article 60) widened their scope: vaccinations under the National Plan for people aged twelve and over by pharmacists who have passed the qualifying course of the Istituto superiore di sanità (National Institute of Health), tests with nasal, saliva or oropharyngeal samples, point-of-care tests against antibiotic resistance in support of the doctor, telemedicine, hepatitis C screening, first-level tests no longer limited to self-monitoring, and dispensing on behalf of healthcare facilities of medical devices too for patients in home, residential and semi-residential care. The new services are paid for by users (paragraph 2). The 2026 Budget Law then made the services a permanent part of the national health service and recognised contracted pharmacies as facilities that provide healthcare and social care services (Law No. 199 of 30 December 2025, Article 1(351)), leaving remuneration to national and regional agreements.

The most practical new development for the business is the possibility of providing services in premises separate from the pharmacy (Article 60(3) to (6)), subject to authorisation by the health authority, which checks hygiene and health standards and that the premises fall within the pharmacy’s area in the pianta organica. In the separate premises it is prohibited to collect prescriptions and to sell medicines or other products; a ‘Farmacia dei servizi’ (pharmacy of services) sign is required next to the green cross. Several pharmacies with different owners may provide services jointly under a network contract. Before signing a lease for this purpose an advance opinion from the Azienda USL is needed. L.R. 2/2016 (Article 17) in any event prohibits the practice in a pharmacy of professions that confer the right to prescribe.

Online sales, advertising, vending machines and parapharmacies

Distance selling is allowed only for non-prescription medicines, by pharmacies and by the outlets referred to in Article 5 of Decree-Law 223/2006, subject to authorisation by the authority designated by regional law and with the common European logo linked to the Ministry of Health’s list (Article 112-quater of Legislative Decree No. 219 of 24 April 2006). Any change in the details must be notified within thirty days. Prescription medicines may not be sold online under any circumstances.

On the delivery of medicines through vending machines, code-operated lockers or kiosks with a remote pharmacist, the Ministry of Health has taken a restrictive view, referred to in a FOFI circular of 1 July 2026: delivery is part of dispensing and requires a pharmacist.

Advertising to the public is allowed only for non-prescription medicines and requires ministerial authorisation, with tacit approval after forty-five days (Article 118 of Legislative Decree 219/2006). Discounts are unrestricted on all products paid for directly by the customer, provided they are clearly communicated (Article 11(8) of Decree-Law 1/2012). Parapharmacies sell only non-prescription medicines, with a pharmacist present; the prohibition on selling Class C prescription medicines outside pharmacies has been held compatible with EU law (Court of Justice of the EU, 5 December 2013, Joined Cases C-159/12 to C-161/12, Venturini) and with the Constitution (Constitutional Court judgment No. 216/2014).

Narcotic drugs

Presidential Decree No. 309 of 9 October 1990 requires a register of receipts and issues of narcotic and psychotropic substances, with entries in chronological order, without blank spaces or erasures, made within forty-eight hours of dispensing for medicines in Tables A, B and C, and kept for two years from the last entry (Article 60). Failure to comply with the rules on registers is punishable by detention of up to two years or a criminal fine (ammenda), unless the conduct constitutes a more serious offence; mere irregularities in keeping the register carry an administrative fine of €500 to €1,500 (Article 68(1) and (1-bis)). The line between a formal irregularity and a substantive breach is drawn by the stock figures: an unexplained shortfall changes the nature of the proceedings, and documented periodic reconciliations are the best defence. Expired narcotic drugs follow the destruction procedure under Presidential Decree 309/1990, which is not the same as the tax procedure: both are needed.

Inspections, closures and penalties

In Emilia-Romagna supervision is the responsibility of the Azienda USL; inspections are carried out by a pharmacist with a doctor from the Department of Public Health and administrative staff, who act as judicial police officers or agents (Article 16 of L.R. 2/2016). In Lombardy the ATS inspection committees operate.

Administrative fines follow Law No. 689 of 24 November 1981, and procedural defects are common: the breach must be notified on the spot or served within ninety days of its establishment (Article 14), payment of a reduced amount is allowed within sixty days (Article 16), written defence submissions and a request for a hearing must be filed within thirty days (Article 18), and an appeal against the ordinanza-ingiunzione (the injunction order imposing the fine) is brought before the ordinary courts within thirty days of service. The inspection report should be read immediately and, if inaccurate, disputed in writing: statements made on the spot by the employed pharmacist on duty are often the hardest evidence to overcome.

The most serious measures are not financial: temporary closure and forfeiture (Article 113 of the consolidated Act on health laws; in Emilia-Romagna they are ordered by the Comune). These measures are challenged before the TAR within sixty days, with an application for interim relief when the harm is imminent.

Staff

After purchases of goods, staff are a pharmacy’s largest cost, and they are largely professionals on a professional register, with their own pension fund and responsibilities towards the patient that do not depend on their contract. Hence the particular features of pharmacy payroll: two overlapping pension schemes, duty rotas imposed by the health authority, and services that bring the risks of a clinic to the counter.

Which collective agreement

Private pharmacies as a rule apply the CCNL for employees of private pharmacies signed by Federfarma with Filcams-Cgil, Fisascat-Cisl and Uiltucs (CNEL code H121). The text in force derives from the agreement of 7 September 2021, which replaced the 2009 agreement after a long gap and expired on 31 August 2024. At the date of this guide the renewal has not been signed: after the breakdown in 2025, the national strike and a conciliation procedure that ended without agreement in February 2026, negotiations have stalled and the parties remain far apart on pay. The expired agreement continues to govern employment relationships, but the budget should allow for back pay or a one-off payment for the period without an agreement, which has been the rule in the sector’s renewals.

The 2021 agreement reorganised the job classification: the managerial (quadri) band covers the director and the employed pharmacists (farmacisti collaboratori), with a Q2 level for an employed pharmacist with a high degree of specialisation and duties connected with the pharmacy of services; the levels for non-graduate staff follow. Placement is checked against the job descriptions: an employed pharmacist who in practice runs the services may claim the higher level, and disputes arise precisely where the pharmacy has expanded its services without reviewing job grades. Minimum pay rates should be taken from the text filed with the CNEL (National Council for Economics and Labour) or from the parties’ official tables.

Pharmacies run by local authorities or in which they hold an interest apply the CCNL for special pharmacies signed by Assofarm with the same three unions (CNEL code H124). For this agreement a draft renewal was signed in mid-September 2026, which must be approved by workers’ meetings. According to the parties’ press releases it provides for increases in several instalments from October 2026, a one-off payment in 2027, a professional allowance for pharmacists, higher supplements for Sunday and public holiday work and a pool of paid time off from 2027. Until the final text is published it is advisable to apply the instalments subject to later adjustment.

Anyone thinking of applying agreements signed by minor organisations or designed for retail trade should remember that statutory and contribution benefits, including relief from contributions on new hires, require compliance with agreements signed by the comparatively most representative organisations (Article 1(1175) of Law 296/2006), and that the courts measure the sufficient pay required by Article 36 of the Constitution against the minimum rates of the sector agreement. The apparent saving can easily turn into a claim for unpaid contributions and pay differences.

Working hours, night work, night duty and part-time

Opening hours, Sunday opening and duty rotas are not decided by the owner, and the organisation of work must adapt to that external constraint. Collective agreements treat differently night work with the doors open, night duty with the doors closed and an obligation to answer calls, on-call availability outside the pharmacy, and work on a rest day or public holiday. The percentages must be read in the agreement applied: some supplements do not apply cumulatively, and the most common payslip error is precisely adding night and public holiday supplements together where the agreement provides that one absorbs the other. Whether night-duty hours are working time is a question of law, which we deal with in the next chapter.

Anyone who regularly works night shifts is a night worker within the meaning of Legislative Decree 66/2003, with an average limit of eight hours in twenty-four and medical checks before starting and at least every two years thereafter (Article 14). In small pharmacies this obligation is forgotten, because night duty comes round in rotation and nobody thinks of themselves as a night worker; yet the rule exists to protect the health of those who work nights, and it should be checked against the annual duty calendar.

Part-time staff often cover extended opening hours. Flexible-hours clauses must be agreed in writing, with the notice and supplements set by the agreement (Article 6 of Legislative Decree 81/2015); systematic use of additional hours that in practice turns part-time work back into full-time exposes the employer to a claim for conversion of the relationship and to findings by the labour inspectorate.

2026 tax relief: night work, public holidays, pay increases, bonuses

For pharmacies, with their night and public holiday duties, the most relevant 2026 provision is Article 1(10) and (11) of Law 199/2025. It applies a 15% substitute tax, up to €1,500 a year, to supplements and allowances for night work, for work on public holidays and weekly rest days and to shift allowances provided for by CCNLs, for private-sector employees whose 2025 employment income did not exceed €40,000. In circular No. 2/E of 24 February 2026 the Agenzia delle Entrate (Italian Revenue Agency) included on-call allowances provided for by the CCNL and connected with this work, and public holiday or night overtime, and excluded amounts provided for only by local or company agreements. Where regional supplementary agreements exist, the part deriving from the national agreement must therefore be identified item by item. The regime applies without an application, unless the employee waives it in writing; contributions remain ordinary. It must be applied no later than the year-end adjustment.

Increases under renewals signed between 2024 and 2026 and paid in 2026 are subject to a 5% substitute tax if 2025 employment income does not exceed €33,000 (Article 1(7)): this concerns the first instalments of the Assofarm renewal and would concern a Federfarma renewal signed within the year. Performance bonuses paid in 2026 and 2027 are taxed at 1% up to €5,000 (paragraph 9), for employees whose income in the previous year was up to €80,000, provided they are set out in a filed company or local agreement and linked to measurable improvements, such as the number of services provided or a reduction in expired stock.

The threshold for tax-free fringe benefits for 2025, 2026 and 2027 is €1,000, or €2,000 for those with dependent children for tax purposes (Law 207/2024, Article 1(390) and (391)); if it is exceeded, the whole amount becomes taxable. Staff discounts on the pharmacy’s products are fringe benefits that must be valued and brought within the threshold: this item is almost always overlooked. Electronic meal vouchers are tax-free up to €10 a day from 1 January 2026 (point (c) of Article 51(2) TUIR, as amended by Article 1(14) of Law 199/2025), paper vouchers up to €4.

Two pension schemes: ENPAF and INPS

Every pharmacist on the professional register is by law a member of ENPAF (Ente nazionale di previdenza e assistenza farmacisti, the pharmacists’ pension and welfare fund), whatever kind of work he or she does. An employed pharmacist therefore contributes to two schemes: INPS (National Social Security Institute) contributions, paid by the employer as for any employee, and the ENPAF contribution, which is personal, fixed in amount and paid by the pharmacist. For 2026 the full contribution is €5,430; an employee covered by another compulsory pension scheme may apply for the reductions offered by the fund (up to 85%) or pay only the 3% solidarity contribution, which gives no pension cover; an unemployed pharmacist may, for a limited period, pay only the 1% solidarity contribution. The 2026 instalments were due on 31 March, 30 April and 30 September. The employer is not required to reimburse ENPAF contributions to the employed pharmacist; where it does so by agreement, the reimbursement is taxable pay for all purposes.

For owners, shareholders and family members the picture is more complex.

• Sole owner who is a pharmacist. Pays into ENPAF and, according to settled practice, is not registered with the INPS scheme for traders (gestione commercianti) for work in the pharmacy; however, he or she must appear as a ‘notional’ owner when registering family helpers.
• Pharmacist shareholder who works in the company. This is the most disputed point. In a note of 29 July 2010 addressed to Federfarma, INPS acknowledged that pharmacists on the professional register and in ENPAF are not required to register with other schemes for income from the pharmacy. The Court of Cassation, by order of 19 November 2012, No. 20268, held instead that traders’ contributions were due from a general partner who worked in the business, even though he was a member of another fund. Case law looks at personal, habitual and predominant participation in the business, and the Institute’s note does not have the force of law. The prudent course is to document the role and registrations of each shareholder and, where a pharmacist shareholder works regularly in a partnership, to allow for the risk of a claim from the traders’ scheme.
• Non-pharmacist shareholder who works. As a rule falls within the traders’ scheme. A shareholder who merely contributes capital is not registered, but the articles of association and filings with the Business Register should exclude any operational role, otherwise registration by the authorities is easily triggered.
• Remunerated director. According to INPS, a company director must be registered with the gestione separata (the INPS separate scheme for the self-employed and directors) even if a pharmacist, because the office of director is not the same as the professional activity covered by ENPAF. This position is disputed and should be assessed when deciding how to remunerate the shareholder.
• Family helpers. A non-pharmacist family member who works habitually and predominantly, typically in a family business (impresa familiare), must be registered as a helper (coadiutore) in the traders’ scheme, with contributions paid by the owner; a family member who is a pharmacist remains in ENPAF. A family member hired as an employee follows the ordinary rules, but the fact that the work is paid must be proven by traceable payments, because INPS closely scrutinises employment relationships between people who live together.
• INAIL. The INAIL (National Institute for Insurance against Accidents at Work) premium is due for shareholders who do manual or supervisory work in the company, pharmacists included; the sole owner is not subject to the obligation and may consider private cover.

Self-employed pharmacists and substitutes

A self-employed pharmacist who covers holidays, sickness and weekends is a common and lawful arrangement, but the label on the contract does not determine the nature of the relationship: it is employment (Article 2094 of the Civil Code) when the pharmacist is subject to the owner’s power to direct, organise and discipline. The indicators are working hours set by the pharmacy, regular inclusion in the rotas, pay by time rather than by assignment, absence of risk, exclusive use of the pharmacy’s resources, and holidays agreed in the same way as an employee’s.

Point (b) of Article 2(2) of Legislative Decree 81/2015 excludes the intellectual professions that require registration on a professional register from the rule applying employment law to collaborations organised by the principal. The rule in paragraph 1 therefore does not apply to a pharmacist registered with the Order: only the traditional test of subordination remains, and the outcome turns entirely on the factual indicators. In judgment No. 24082 of 7 September 2021 the Court of Cassation set aside an injunction order against the owner of a rural pharmacy concerning the work of a self-employed pharmacist, holding that the notification obligations at issue did not apply to registered professions; the inspection report, however, had recorded that the pharmacist gave the owner notice of her holidays and held the keys to the pharmacy, which are precisely the elements on which another court could have found an employment relationship. The self-employed pharmacist must be genuinely free: agreeing availability rather than being assigned to rotas, invoicing defined services and not working the same hours as employees. The written contract, calendars and invoices should be kept together.

For pension purposes a self-employed pharmacist pays into ENPAF and not into the INPS gestione separata: Article 18(12) of Decree-Law 98/2011, an authentic interpretation of Article 2(26) of Law 335/1995, limits registration with the gestione separata to those who carry out self-employed work for which registration on a professional register or with a professional pension fund is not required (Constitutional Court judgments No. 104/2022 and No. 55/2024).

Substitution of the owner follows its own rules. Article 11 of Law 362/1991 allows, with the authorisation of the health authority, temporary substitution by another pharmacist on the register in cases of sickness, serious family reasons, maternity, public or trade union office and holidays, within time limits; regional laws govern short absences and notifications. The substitute may be an employee or self-employed, with the risks just described in the latter case. As we have seen, a shareholder who works in the pharmacy cannot also be its employee (point (c) of Article 8(1) of Law 362/1991): he or she is remunerated through profits or through a director’s fee.

Health and safety, healthcare services and training

Pharmacies are classified in the services sector of the INAIL tariff; the tariff item and rate should be checked every year, because an initial error carries over from year to year. Healthcare services have changed the risk profile: swabs, capillary blood tests, vaccinations and measurements bring a biological risk that must be assessed in the risk assessment document under Title X of Legislative Decree 81/2008, with dedicated areas, protective equipment, disposal of sharps, procedures for needlestick injuries and health surveillance for exposed staff.

Night duty carried out by a single pharmacist is the most delicate case. The DVR (documento di valutazione dei rischi, the risk assessment document) must assess lone working and the risk of assault and set out the measures: a hatch or medicine pass-through for duty with the doors closed, video surveillance in compliance with Article 4 of Law 300/1970, an alarm, and procedures for cash and for robbery. A robbery suffered while on duty is an accident at work and must be reported to INAIL even when the consequences are psychological rather than physical, and after a robbery these should never be underestimated.

Health and safety training is paid for by the employer and takes place during working hours. ECM (continuing medical education) is instead a personal obligation of the pharmacist (150 credits in the three years 2026-2028, subject to exemptions and reductions). An employer who supports it with courses or time off should do so under a written policy, to avoid unequal treatment and to treat the reimbursement as a training cost of the business when the course is in the business’s interest. When the employer requires particular clothing for reasons of hygiene or identification, coats and their upkeep are at its expense; protective equipment always is (Articles 18 and 77 of Legislative Decree 81/2008).

Hiring, incentives, apprentices and trainees

The 2026 incentives come from Decree-Law No. 62 of 30 April 2026, converted into law by Law No. 112 of 25 June 2026: full relief from employer contributions, within monthly limits, for permanent hires made in 2026 of young people under 35 and of disadvantaged women, with the instructions in INPS circulars No. 55 and No. 57 of 14 May 2026 and an application through the incentives portal. In addition there is relief for working mothers of at least three children under Law 199/2025. No measure has yet been approved for 2027: a hire planned for January and brought forward to December may keep the relief.

For non-graduate sales assistants, warehouse staff and counter staff, the vocational apprenticeship (Articles 44 et seq. of Legislative Decree 81/2015) remains the most cost-effective tool, with reduced employer contributions and a more favourable regime for businesses with up to nine employees. It does, however, require a genuine training plan and a tutor; otherwise, in an inspection, the relationship is reclassified.

The traineeship for pharmacy students is now part of the qualifying course. Under Law 163/2021 and Ministerial Decree No. 651 of 5 July 2022 the master’s degree qualifies graduates to practise and includes a six-month practical and assessed traineeship of 900 hours, at least 450 of them in a pharmacy open to the public, governed by an agreement with the university. It is a curricular traineeship, not an employment relationship, without the minimum allowance for extracurricular traineeships and with insurance cover usually provided by the university. The trainee may not staff the counter in place of employees: the pharmacy would expose itself to findings on the presence of a qualified pharmacist.

Employment law: the pharmacy’s sticking points

Night duty and on-call availability: when it is working time

The concept of working time is the one in point (a) of Article 1(2) of Legislative Decree 66/2003, which transposes Directive 2003/88/EC as interpreted by the Court of Justice (judgment of 21 February 2018, C-518/15, Matzak, and judgments of 9 March 2021, C-344/19 and C-580/19). A period of on-site duty or on-call availability is entirely working time when the constraints imposed objectively and very significantly affect the worker’s ability to manage his or her own time: what counts is the obligation to remain in a particular place, the response time required and the actual frequency of calls.

Applied to pharmacies, this test leads to a clear distinction. A pharmacist who stays overnight on the premises or in the building for duty with the doors closed is tied to the workplace: those hours are working time even if nobody rings the bell. The Court of Cassation confirmed this, for night duty on site, in its order of 23 April 2025, No. 10648, adding however that the classification does not automatically mean night overtime pay: pay must be proportionate and sufficient under Article 36 of the Constitution and may be set by collective bargaining. A pharmacist on call at home, with a reasonable response time, is normally not working except for the time spent responding; with frequent calls or response times of a few minutes the assessment may be reversed.

The consequences are not limited to the payslip. If night duty is working time, it counts towards the daily rest of eleven consecutive hours (Article 7 of Legislative Decree 66/2003) and towards the maximum average working week (Article 4). A shift that runs from a day at the counter through the night on duty into the following morning is first and foremost a risk for the patient and for the worker: it exposes the employer to administrative fines and, if a dispensing error is made through tiredness, to a far more serious liability issue.

Sale, lease, contribution and succession: the employees

When a pharmacy changes owner, Article 2112 of the Civil Code applies: employment relationships continue with the transferee, employees keep their accrued rights, and transferor and transferee are jointly and severally liable for claims outstanding at the time of the transfer. The Court of Cassation has applied the rule to the lease of a pharmacy as well (Cass. 11 May 2011, No. 10340), because what counts is the change in ownership of the business organisation, whatever the transaction used. The transferor is released from employees’ claims only through waivers and settlements made in a protected forum (Articles 410 and 411 of the Code of Civil Procedure); a statement signed in the pharmacy is not enough. Above fifteen employees the transaction must be preceded by the notification and any consultation with trade unions under Article 47 of Law 428/1990.

The transfer is not in itself a ground for dismissal (Article 2112(4)). A buyer who arrives with plans of his or her own, perhaps intending to act as director personally, may dismiss only for a genuine objective justified reason, subject to the ordinary rules on redeployment (repêchage) and the protections of Legislative Decree 23/2015 or of Article 18 of the Workers’ Statute according to the hiring date and the size of the business. An employee whose conditions undergo a substantial change in the following three months may resign for just cause. ‘Agreed’ dismissals before the transfer are to be avoided, because the court looks at their substance. And the staff who know the patients are often part of the value that has been paid for.

Municipal pharmacies and publicly owned companies

Companies with public shareholders that run municipal pharmacies hire under private-law employment relationships, but must recruit through transparent and impartial selection procedures, and contracts concluded without these procedures are void (Article 19(1), (2) and (4) of Legislative Decree 175/2016). In judgment No. 2538 of 27 January 2022 the Court of Cassation upheld the dismissal of an employee of an in-house company hired directly without selection: nullity applies regardless of the worker’s good faith; pay and contributions for the period worked are preserved (Article 2126 of the Civil Code), but a permanent relationship cannot arise and, according to settled case law, unlawful fixed-term contracts cannot be converted. An ‘urgent’ hire to cover a summer without a public notice is a void contract, with possible liability of the directors for loss to the public purse. When the Comune changes its management model, the transfer of staff depends on the form of the transaction: transfer of a business under Article 2112 of the Civil Code or a social clause included in the tender documents (Article 57 of Legislative Decree 36/2023).

Cash shortfalls, stolen goods and deductions from pay

Shortfalls, stock discrepancies, expired stock not returned in time, and thefts of valuable products are the most common grounds for disciplinary action. An employee is liable for damage caused intentionally or negligently (Articles 1218 and 2104 of the Civil Code), but the employer must prove the damage, that the employee caused it and which duty of care was breached. If several people work at the till without separate operator codes, individual proof is almost impossible and a collective charge does not stand up. Before taking action it is advisable to rule out trivial causes, such as an unrecorded return or wrong change given during a rush: an unfounded accusation costs more than the shortfall.

A deduction from pay ‘by way of reimbursement’ decided unilaterally is the riskiest route and, as a rule, the employee recovers it. Holding an employee responsible for an incident requires the disciplinary procedure under Article 7 of the Workers’ Statute (written notice of the charge, at least five days for a defence, a proportionate sanction), and a fine may not exceed four hours’ basic pay. Compensation is a different matter: it must be established and, unless the employee acknowledges it in a written agreement on the specific incident, it must be claimed in court.

The Court of Cassation is strict with those who steal goods. In judgment No. 29137 of 4 November 2025, according to published commentaries, it upheld the summary dismissal of a private pharmacy employee with over thirty years’ service who had taken medicines and parapharmaceutical products worth around €18,000. The disciplinary charge was held to be timely even though it came after the accounting checks carried out by the pharmacy’s accountants, because promptness is measured from full knowledge of the facts, and the decision rested on accounting, witness and documentary evidence, not on video footage alone.

Cameras and the pharmacy management software

No general rule makes video surveillance compulsory in pharmacies, but whatever the reason it is installed, a system that also makes it possible to monitor employees remotely falls under Article 4(1) of Law 300/1970: it may be installed only for organisational and production needs, workplace safety or the protection of company assets, subject to an agreement with the workers’ representatives or, failing that, authorisation from the Labour Inspectorate. INL (National Labour Inspectorate) circular No. 5 of 19 February 2018 set the criteria for assessing applications. Individual employees’ consent does not replace the agreement or authorisation.

For the till terminal, personal log-ins to the management software and the sales register, which the employee uses to do the job, no agreement is needed (Article 4(2)). However, the data may be used for disciplinary purposes only if the employee has been informed of how the tools are used and of possible checks (paragraph 3). A written policy is needed stating that sales, returns, reversals and cancellations are tracked by operator and may be examined: without that document the printout of anomalous reversals may well be inadmissible in court.

The same policy must prohibit looking up the prescriptions or data of acquaintances without a work reason, which is a serious disciplinary breach and, for a pharmacist, also a breach of professional confidentiality; employees must be authorised and instructed in writing to process health data (Article 29 of Regulation (EU) 2016/679 and Article 2-quaterdecies of Legislative Decree 196/2003). Defensive checks in the strict sense remain possible: targeted at one employee, ordered after a well-founded suspicion of a specific wrongdoing and limited to data collected from that moment onwards (Cass. 22 September 2021, No. 25732). A blanket review of the video archives of recent months is not such a check.

The employed pharmacist who opens or buys nearby

It is in the nature of the profession that an employed pharmacist may enter a competition or join a company taking over a nearby pharmacy; the question is how and when. During the employment relationship Article 2105 of the Civil Code prohibits doing business in competition with the employer and using the business’s information to its detriment. Case law is not uniform on merely preparatory acts: Cass. 15 December 2003, No. 19132 held them insufficient unless they turn into acts of management; the order of 11 April 2019, No. 10239 upheld the dismissal of an employee who had failed to disclose that he had formed a potentially competing company.

The dividing line is the use of information: taking part in a competition is not unlawful, taking away the list of chronic patients, suppliers’ terms or sales data by department is. After termination competition is free, unless there is a non-compete covenant complying with Article 2125 of the Civil Code (in writing, with consideration, limits as to scope, time and place, a maximum of three years for non-executives), which must be drafted with care because a restriction that in practice prevents a pharmacist from working in his or her own area is likely to be void.

Irregular dispensing and assaults

Supplying prescription-only medicines without a prescription outside emergencies, or keeping the narcotics register badly, exposes the employee and the owner to administrative, professional disciplinary and, in serious cases, criminal penalties. Such conduct goes to the owner’s trust in the professional who stands in for him or her at the counter, but procedure matters: a dismissal fails if the charge is vague or late, if the employee has not been heard, if the disciplinary code is not posted or if the sanction is disproportionate. An occasional error, without intent and without harm, perhaps prompted by a wish not to leave a patient without treatment, rarely justifies dismissal; a repeated practice of sales ‘pending a prescription’ that are never regularised is a different matter, to be reconstructed from registers, operator printouts and prescriptions.

Assaults are increasingly frequent, especially at night and where controlled medicines are dispensed. Article 583-quater of the Criminal Code, as amended by Law 113/2020, imposes heavier penalties for injuries to staff practising a healthcare profession, and Decree-Law 137/2024 extended arrest in flagrante delicto. On the employment side, Article 2087 of the Civil Code makes the employer the guarantor of its staff’s safety: if the assault was foreseeable and the measures in the DVR were missing, the employee’s injury also becomes a matter of employer liability, beyond INAIL cover. After an incident, reviewing rotas and measures together with the person who suffered it is the first step, for the DVR too.

VAT

The activity code after ATECO 2025

Under the ATECO 2025 classification, in use since 1 April 2025, pharmacies remain in class 47.73, but code 47.73.10 is now called retail sale of medicines subject to medical prescription. The sale of non-prescription medicines typical of parapharmacies is placed in subcategory 47.73.90. For a pharmacy open to the public the main code remains 47.73.10 even when the non-prescription part weighs heavily in turnover: it is the code to which the sector’s reliability index is linked, and a wrong code in the Business Register extract or in the tax return brings a wrong index with it.

VAT rates: at least four regimes at the counter

The starting point is item 114 of Table A, Part III, of Presidential Decree 633/1972: a 10% rate for medicines ready for human or veterinary use, including homeopathic medicines, and for pharmaceutical substances and dressings that pharmacies are required to stock under the pharmacopoeia. The 10% rate applies to prescription medicines (etici), SOP (non-prescription medicines that may not be advertised) and OTC (over-the-counter) medicines; it does not apply to animal feed and pet food, which bear the standard rate.

Medical devices are where most mistakes are made. The rate in item 114 extends to devices only if they can be classified under customs heading 3004 (medicaments), according to the authentic interpretation in Article 1(3) of Law 145/2018 and circular No. 8/E of 10 April 2019. CE marking alone is not enough, and replies to ruling requests (risposte a interpello) must be read case by case: for ophthalmic products reply No. 257/2023 accepted the 10% rate after a technical opinion from the Agenzia delle dogane (Customs Agency), while reply No. 345/2023 refused it. The 4% rate covers orthopaedic appliances, prostheses and other appliances that compensate for a deficiency or infirmity (Table A, Part II, item 30) and aids for permanent functional impairments (item 41-quater), the latter with the documentation required by the Ministerial Decree of 14 March 1998: without that documentation, an aid sold at 4% exposes the seller to recovery of the tax.

Cosmetics, hygiene products, healthcare items without a reduced rate and most parapharmaceutical products bear 22%. Food supplements have no rate of their own: the 10% rate applies only if the product falls under customs heading 2106 (food preparations not elsewhere specified), to be established through a technical opinion from ADM (Agenzia delle dogane e dei monopoli, the Customs and Monopolies Agency) (resolution 50/E/2021, reply No. 305 of 5 December 2025); otherwise 22% applies. Gluten-free foods also follow the product’s commodity classification. Sanitary products and baby products (infant milk and formula, nappies), after the 5% interlude in 2023, returned to 10% from 1 January 2024 under Law 213/2023.

The practical risk is applying the reduced rate on the basis of the supplier’s product sheet, while the tax difference is borne by the seller: for fast-moving devices and supplements it is advisable to insist on the customs classification and, in doubtful cases, the ADM opinion. Gift boxes and kits are trickier: the cream with a device, the supplement with a cosmetic, the gift pack. According to the Court of Justice, a single supply, with a principal element and other ancillary elements, bears the rate of the principal element (Case C-349/96, Card Protection Plan; Case C-463/16, Stadion Amsterdam), whereas independent goods each bear their own rate; for sets, customs classification looks at the component that gives the set its essential character. Without information from the supplier, the prudent choice is the higher rate.

The pharmacy’s services: exemption and pro rata

The exemption in Article 10, point 18, of Presidential Decree 633/1972 requires two conditions together: a service of diagnosis, treatment or rehabilitation, provided by a qualified healthcare professional. In resolution 128/E of 20 December 2011 the Agenzia accepted it also when the service is provided in a pharmacy by nurses and physiotherapists, both in their relationship with the pharmacy and in that between the pharmacy and the patient. Resolution 60/E of 12 May 2017 then drew distinctions between services:

• services of qualified healthcare professionals requested by a doctor, and support in the use of second-level devices prescribed by a doctor (electrocardiogram or Holter monitoring by telemedicine with remote reporting), are exempt;
• first-level self-monitoring tests carried out by the patient with automatic devices, and CUP (single booking centre) booking services, collection of prescription charges and collection of test results, are taxable at 22%;
• services provided by social care workers, who are not healthcare professionals, bear the standard rate (reply No. 90/2018).

Reply No. 466 of 21 September 2022 added a purpose requirement: if the main purpose is not the protection of health (the ‘wellness’ package, nutritional advice sold as a product), the exemption does not apply even if a doctor is involved. Paid vaccinations given by a qualified pharmacist have been treated, according to commentaries on the Agenzia’s practice, as a single exempt healthcare service in which the supply of the vaccine is ancillary; with the extension of services under Law 182/2025 an updated official clarification would be useful. The special regime of exemption with the right to deduct for Covid swabs and vaccines (Article 1(452) and (453) of Law 178/2020) ended on 31 December 2022: anyone who still has VAT codes from that period in their accounts would do well to check them.

There are no specific official guidance documents on telemedicine: in our view the exemption holds if the report is signed by a qualified doctor and the documentation shows this. The hire of equipment (breast pumps, nebulisers, scales) is not a healthcare service and, in the absence of a relieving provision, bears the standard rate.

Daily takings and ventilazione

A pharmacy certifies counter sales with the documento commerciale (commercial receipt) issued by the online cash register, which stores the daily takings and transmits them to the Agenzia (Article 2 of Legislative Decree 127/2015); an invoice is issued at the customer’s request, at the latest when the transaction takes place. A deposit received for a product to be ordered (an aid, a compounded preparation) means that the supply is treated as made for the amount paid (Article 6, fourth paragraph, of Presidential Decree 633/1972) and must be certified immediately; the balance is certified on delivery.

A pharmacy may account for VAT using ventilazione dei corrispettivi (the apportionment of daily takings among VAT rates on the basis of purchases) (Article 24, third paragraph, of Presidential Decree 633/1972 and Ministerial Decree of 24 February 1973), which is reserved for retailers in certain categories, including pharmaceutical and personal hygiene products: takings are recorded without distinguishing rates and are apportioned in proportion to purchases of goods intended for resale, with a progressive calculation and a year-end adjustment. The decree sets two limits to be checked every year: ventilazione cannot be used in the following year if purchases of goods other than those allowed exceed 50% of the total or if the consideration for invoiced sales, excluding capital goods, exceeds 20% of the total.

There has been confusion about the future of the method. The draft legislative decree approved on a preliminary basis on 22 July 2025 provided for its abolition from 2026; the final text, Legislative Decree No. 186 of 4 December 2025, does not contain that provision, and ventilazione remains available. From 1 January 2027 Article 24 will be replaced by the consolidated VAT Act, which reorganises the rules without changing their substance. Today, however, management software assigns a rate to every product line in any case, and those who can should consider recording takings by rate. Ventilazione is not neutral: if the mark-up on parapharmaceutical products is higher than on medicines, apportioning on the basis of purchases assigns fewer sales to the 22% rate than were actually made. The method is lawful, but an audit that reasons in terms of margins will see the difference; a numerical comparison is given in the worked examples.

One point that calls for a documented and consistent choice is the coordination between national health service takings and apportioned takings: if the SSN part is recorded separately with its own rate, the purchase base for ventilazione must be treated consistently, otherwise the apportionment is distorted. There is no official guidance on this point; a written internal rule is needed, always applied in the same way.

Sistema Tessera Sanitaria, receipts and the patient’s tax credit

For the patient, the pharmacy is where the 19% tax credit (point (c) of Article 15(1) TUIR) originates, and a wrong receipt becomes a problem for the patient, who often notices it only when filing the tax return. The scontrino parlante (the itemised receipt showing the customer’s tax code) must state the nature, quality and quantity of the goods and the tax code of the recipient. Medical devices qualify if they bear the CE marking (circular 20/E/2011) and the document must make it possible to identify them as such; food supplements do not qualify even if prescribed (resolutions 256/E and 396/E of 2008), nor do parapharmaceutical products and cosmetics. For medicines and medical devices bought in a pharmacy, the requirement of traceable payment that applies to other expenses qualifying for tax credits does not apply (Article 1(680) of Law 160/2019).

The same data are sent to the Sistema Tessera Sanitaria (the national health card data system) for the pre-filled tax return. For expenses from 1 January 2025 transmission is annual, by 31 January of the following year (Legislative Decree 81/2025 and Ministry of Economy and Finance decree of 29 October 2025). Customers may object to the use of their data, and the pharmacy must record the objection without sending the tax code. The coding of products in the management software, distinguishing medicines, devices and parapharmaceutical products, is the same coding needed for the VAT rate, for ventilazione and for the patient’s tax credit: an error in the product master data is multiplied across three obligations.

Card terminals and the online cash register

From 1 January 2026, under Article 1(74) to (77) of Law 207/2024, electronic payment terminals must be linked to the online cash register. The link is logical: the pairing between the card terminal and the serial number of the cash register is notified in the ‘Fatture e Corrispettivi’ (Invoices and Daily Takings) area, under the Agenzia’s measure of 31 October 2025, ref. 424470. Replacing the terminal or opening a new collection account requires a new notification, and it is easy to forget. The most significant practical effect is that the Agenzia can cross-check electronic receipts against daily takings: a pharmacy that uses the same card terminal for invoiced receipts, services or other activities must be able to explain every difference.

The national health service: the DCR and remuneration since 2024

The supply of a medicine under the health service agreement is certified by the receipt and summarised in the monthly DCR (distinta contabile riepilogativa), on the basis of which the local health authority pays net of deductions. It is a supply of goods taxable at 10% and not subject to split payment, because it is not documented by an invoice.

From 1 March 2024 the remuneration system changed (Article 1(225) to (228) of Law 213/2023). Instead of the old margin, the pharmacy receives a variable fee of 6% of the retail price net of VAT and a fixed fee per pack: €0.55 for a price up to €4, €1.66 between €4.01 and €11, €2.50 above €11, plus €0.115 from 2025 for medicines on the transparency lists.

Pharmacies with modest SSN turnover receive additional fees per medicine: €1.20 up to €150,000, €0.58 up to €300,000, €0.62 for subsidised rural pharmacies up to €450,000 (paragraph 227). For medicines moved from A-PHT distribution to Class A with a price above €100, the percentage fee is calculated as if the price were €100 (paragraph 225-bis, introduced by Law 199/2025). And, a point that many financial statements have not yet reflected, from 1 March 2024 the discounts in favour of the national health service no longer apply: the price-related discount under Article 1(40) of Law 662/1996, the one under the AIFA determination of 9 February 2007, the one under Decree-Law 156/2004 and the one under Article 11(6) of Decree-Law 78/2010 (paragraph 228). Deductions that still appear in the DCR must be examined one by one, because they are no longer statutory discounts.

In reply to request for legal advice (consulenza giuridica) No. 5 of 20 June 2025 the Agenzia clarified that all these fees, including the additional ones for small pharmacies, are part of the consideration for the supply of the medicine to the national health service and bear VAT at 10%: they are neither grants outside the scope of VAT nor fees for services.

The DCR must be reconciled every month, line by line, with daily takings and with the bank transfer: prescription charges collected at the counter, rejected prescriptions, deductions, adjustments. Charges on prescriptions can be disputed within the time limits of the health service agreement and regional agreements; letting them go means accepting small losses that add up by year end.

Distribution on behalf of the health service and supplementary care

In DPC (distribuzione per conto) the medicine is bought by the local health authority and passes through the pharmacy without becoming its property: the pharmacy provides a dispensing service remunerated per pack under regional agreements. In this model the fee is consideration for a supply of services to a public body, for which no item in the tables provides a reduced rate: it is invoiced electronically to the health authority at the standard rate of 22% with split payment (Article 17-ter of Presidential Decree 633/1972). There is no specific official guidance document, but this solution follows from the classification of the transaction and is the one adopted by most agreements. Some regional models, however, structure the flow differently, with the pharmacy buying the medicine and reselling it to a body or consortium at a margin, and in that case the transaction is a supply of medicines at 10%. The regional agreement must be read before setting up the VAT code, and the classification must be kept consistent in invoices, accounts and stock.

DPC medicines do not form part of the pharmacy’s closing stock: management software that loads them into stock distorts the inventory and ventilazione. Supplementary care (assistenza integrativa: aids for diabetics, products for coeliacs supplied against vouchers, incontinence aids) is instead a supply invoiced to the health authority under split payment at the rate applicable to the goods. With split payment the VAT is not collected, and a pharmacy with a large volume of DPC and supplementary care may find itself with a VAT credit to be used by set-off.

Free gifts, free goods, payments from manufacturers and vouchers

A pharmacy receives and gives away many things free of charge, and each has a different treatment. Extra items delivered as a discount in kind provided for in the contract terms do not form part of the supplier’s taxable amount for VAT (Article 15, first paragraph, point 2, of Presidential Decree 633/1972) but do enter stock: at zero cost, they generate full revenue when sold. Anyone who does not load them into stock creates exactly the stock discrepancy that the tax office is looking for.

Free gifts to customers of products that the pharmacy sells are taxable free supplies if VAT was deducted on purchase, whatever their value (Article 2, second paragraph, point 4); the €50 threshold applies only to goods unrelated to the business. Rewards in kind from loyalty point schemes follow the same rules; immediate loyalty card discounts reduce the consideration. Free samples of medicines are intended for doctors and do not pass over the counter (Article 125 of Legislative Decree 219/2006).

Amounts paid by manufacturers for the visibility of their products (window displays, display stands, promotional days) are not discounts: they are consideration for a service provided by the pharmacy, to be invoiced with VAT at 22%. Year-end bonuses linked to the volume of purchases, if provided for in the contract, are instead dealt with by a credit or debit note (Article 26 of Presidential Decree 633/1972); the Court of Cassation (judgment 13312/2013) refused a credit note in the absence of a contractual provision. The contract with the manufacturer must state clearly what is being paid for, a service or a discount.

Since 2019 vouchers have been governed by Articles 6-bis, 6-ter and 6-quater of Presidential Decree 633/1972. In a pharmacy, rates of 4%, 10% and 22% coexist with exempt supplies, so a gift card that can be spent on the whole range, like a welfare voucher, is a multi-purpose voucher: no consideration is certified on issue and VAT applies when the voucher is spent, on the products actually bought. The typical error is ringing up the voucher as a sale at 22% and then certifying the goods again when the customer uses it, paying the tax twice. A voucher valid only for a single-rate product line is instead a single-purpose voucher and is taxed on issue.

Income taxes, accounting and audits

Choosing the legal form

The legal form should not be chosen by looking only at the tax rate: succession, investor shareholders, financing of the purchase and who works in the pharmacy all count.

A sole owner pays progressive IRPEF (personal income tax). If the owner’s spouse works at the counter as an employee, his or her pay is not deductible: Article 60 TUIR excludes payments for the work of the spouse, minor or incapacitated children and ascendants, while compulsory contributions remain deductible. The alternative is the impresa familiare (family business) (Article 230-bis of the Civil Code and Article 5(4) TUIR): up to 49% of the income may be allocated to family members who work on a continuous and predominant basis, provided the notarial deed or authenticated private agreement predates the tax year. Since Constitutional Court judgment No. 148/2024 a cohabiting partner counts as a family member of the family business for civil-law purposes; whether the same applies to the allocation of income has not been clarified, and for now it is best not to rely on it.

In a company the problem changes in nature: the pay of a shareholder’s spouse who works as an employee of the company is a deductible cost, if the work is genuine and the pay reasonable. This is one of the arguments, rarely mentioned, in favour of moving to a company when the whole family works in the pharmacy. A partnership allocates its income to the partners on a tax-transparent basis (Article 5 TUIR). An srl (limited liability company) pays IRES (corporate income tax) at 24% and shareholders who are individuals suffer the 26% withholding tax on distributed profits, whatever the size of their holding.

An srl whose shareholders are all individuals, no more than ten in number, and whose revenue is within the statutory limits may elect for tax transparency under Article 116 TUIR, for three years: the income is taxed directly in the hands of the shareholders and the profits of those years, when distributed, are not subject to withholding tax. It is not advantageous when profits remain in the company to repay the acquisition debt, because the shareholders would pay IRPEF on amounts they do not receive. The third route is holding shares through a holding company. After Law 199/2025 dividends received by a company are 95% excluded only if the holding is at least 5% or has a tax value of at least €500,000 (Article 89(2.1) TUIR), and the same threshold applies to the exemption for capital gains (Article 87(1.1)). For a family holding company that controls the pharmacy the condition is normally met, but it should be checked, especially where the shareholder base is fragmented.

A sole owner may move to a company by contributing the business on a tax-neutral basis (Article 176 TUIR), with registration tax at a fixed amount. The company takes over the business’s tax values, so the goodwill built up over the years does not become amortisable, unless the paid realignment provided for by the same article is used. Transactions involving chains or investors require a prior check of the 20% limit on a regional basis and of incompatibilities along the whole chain.

IRAP

Since 2022 a pharmacist who owns a pharmacy as a sole trader has not paid IRAP (regional tax on productive activities) (Article 1(8) of Law 234/2021). Partnerships and companies remain subject to it (Legislative Decree 446/1997), at the standard rate of 3.9%, which the regions may vary: in Emilia-Romagna, from 2026, it is 4.20% for pharmacies (L.R. 1/2025). The cost of permanent employees is deductible. Fees paid to self-employed pharmacists who invoice as professionals are costs for services and are also deductible; fees for continuing and coordinated collaborations and for occasional self-employment, on the other hand, remain non-deductible. Interest expense and IMU (municipal property tax) are not deductible for IRAP purposes; amortisation of purchased goodwill is, up to one eighteenth a year.

Stock: stock count, valuation, expired products

The physical stock count at year end, to be transcribed and signed in the inventory book (Article 15 of Presidential Decree 600/1973), is the basis of everything: the theoretical stock levels in the management software, very useful for reordering, do not replace it, because they accumulate loading errors, unrecorded returns, thefts and expired products.

Alongside the ordinary methods (Article 92 TUIR and OIC 13), retailers may use the retail method: the starting point is the selling price, from which the average mark-up for each homogeneous category is deducted. For tax purposes Article 92(8) TUIR allows it on condition that the criteria and method of application are explained in the return or in an annex; without that schedule the tax authorities may reassess the higher value determined using the ordinary criteria (Cass. No. 28061/2017). In a pharmacy the method works only if mark-ups are calculated for genuinely homogeneous groups (SSN prescription medicines, private prescription medicines, SOP and OTC, parapharmaceutical products, dermocosmetics): a single mark-up on stock in which medicines with regulated margins sit alongside high-margin cosmetics produces values that are hard to defend.

Theft overcomes the presumption of sale if documented by a report to the authorities (Article 2 of Presidential Decree 441/1997), and the quantity must match what was reported and the stock discrepancies; an insurance payout is income of the year in which it becomes certain. Returns, year-end bonuses, invoice discounts and free goods must be managed in the accounts and not only in the management software: a ‘year-end’ bonus collected and recorded in March shifts income from one year to another, whereas it must be recognised on an accrual basis.

Revenue from the national health service, grants and allowances

Revenue from medicines dispensed under the health service agreement accrues in the period of delivery (point (a) of Article 109(2) TUIR), not in the period in which the health authority pays: the December DCR paid in February belongs to the year that is closing. Late-payment interest is taxable when received (Article 109(7)).

The residence allowance for rural pharmacies and other regional operating grants are revenue grants: outside the scope of VAT, they are taxable as revenue (point (h) of Article 85(1) TUIR) and form part of the IRAP base, and they must be recognised on an accrual basis even if payment arrives months late. If the paying body applies the 4% withholding tax under Article 28(2) of Presidential Decree 600/1973, the pharmacy credits it in its tax return; some doubt whether it is owed, but no official document rules it out.

ISA and the concordato preventivo biennale

The ISA (synthetic reliability index) for pharmacies is DM04U, linked to code 47.73.10 and revised by the measure of 17 March 2025. Practitioners report that the index struggles to capture the new SSN remuneration system, which eliminated discounts, and the rise in staff costs, while the 2021-2022 data, inflated by pandemic-related services, still weigh in the historical series. A low score proves nothing, but it must be explained with stock accounts and margins that can withstand an audit. A pharmacy that does not know its margin by category has little to put forward in an audit.

The concordato preventivo biennale (the two-year advance agreement on taxable income, Legislative Decree 13/2024) is available to pharmacies subject to ISA; for the two years 2026-2027 the deadline for opting in was set at 31 October 2026, which, falling on a Saturday, moves to 2 November (circular No. 8/E of 6 October 2026). Opting in makes sense if the proposal is consistent with expected profitability and if no events that would alter income are in sight: a second pharmacy, new shareholders, a large investment in services.

Buying a pharmacy

The price of a pharmacy is almost entirely goodwill, because the value lies in the area, its catchment and the trust that local patients have built up over the years. The first choice is between buying the business and buying the shares in the company that owns it, and the tax effects are very different. When the business is bought, goodwill is recognised in the financial statements and amortised over its useful life (OIC 24, with a ten-year limit when the useful life cannot be estimated); for tax purposes it is deductible at no more than one eighteenth a year (Article 103(3) TUIR), for IRAP too, and the difference between book and tax amortisation is recovered after book amortisation ends. When shares are bought, on the other hand, the price paid in excess of net equity remains in the cost of the shareholding and is not amortised: it will count only on resale.

The sale of a business is outside the scope of VAT (point (b) of Article 2, third paragraph, of Presidential Decree 633/1972) and is subject to proportional registration tax. If the deed states separate prices for each category of asset, the rates specific to each apply (3% for goodwill and movable assets, the real property rates for any premises), with liabilities allocated proportionately (Article 23 of Presidential Decree 131/1986, as amended by Legislative Decree 139/2024); without an allocation, the whole value bears the highest rate.

Interest on acquisition finance follows different rules depending on the legal form. A sole owner and a partnership deduct it in the proportion set by Article 61 TUIR, which in a pharmacy, where almost all revenue is taxable, normally results in full deductibility; a company deducts it up to the amount of interest income plus 30% of EBITDA for tax purposes (Article 96 TUIR), with any excess carried forward. It is not deductible for IRAP purposes.

As for premises, IMU on business property has been fully deductible from business income since 2022, but not for IRAP purposes. A sole owner who uses his or her own premises not recorded among the business assets cannot pay himself or herself rent, and the cost remains outside business income. If the premises belong to the spouse, rent at market value is deductible, because Article 60 TUIR concerns payments for work and not rents; the lease must be registered and the rent reasonable: a rent out of line with the market between family members is the first thing an audit focuses on.

Selling, contributing to a company, leaving to heirs

For the seller the difference between the price and the cost recognised for tax purposes is a capital gain (Article 86 TUIR). The 2026 Budget Law rewrote paragraph 4 of that article (Law 199/2025, Article 1(42)): for capital gains realised from 2026, spreading over five years is no longer available for individual capital assets, but remains for the sale of businesses or business units held for at least three years. An individual owner selling a business held for more than five years may instead opt for separate taxation (point (g) of Article 17(1) TUIR), which is often advantageous for someone ending a working life in a pharmacy; separate taxation and spreading are alternatives, and the comparison must be made with the figures for the year of sale, local surcharges included. For IRAP purposes the capital gain on the sale of a business is not part of the value of production (circular 27/E/2009).

When the owner dies, the business passes to the heirs at the deceased’s tax values, without capital gains (Article 58(1) TUIR). If the heirs then sell, the Court of Cassation adds the deceased’s period of ownership to the heir’s for the five years required for separate taxation (judgment 4444/2022, concerning a sole heir; where several heirs run the pharmacy together the solution must be assessed case by case). During provisional management, heirs who carry on the business together generate income to be declared under the rules for partnerships, and their tax and social security status must be settled at once.

As regards inheritance tax, the transfer of the business to the spouse and descendants is exempt if the heirs continue the business or retain control for at least five years and say so in the inheritance tax return (Article 3(4-ter) of Legislative Decree 346/1990, as amended by Legislative Decree 139/2024). Heirs who, lacking the requirements, sell within the six months lose the exemption and pay the tax with the ordinary tax-free amounts (€1 million per beneficiary for spouses and direct relatives, 4% on the excess). According to circular 3/E/2008, a contribution to a company does not forfeit the relief if it concerns a partnership or if the shares received ensure control of a company. For a valuable pharmacy the difference between selling and contributing often runs to six figures, which is one more reason to consider at once the company route described in the first chapter.

Assessments based on mark-ups: where pharmacies lose their cases

The analytical-inductive assessment of pharmacies (point (d) of Article 39(1) of Presidential Decree 600/1973 and Article 54 of Presidential Decree 633/1972) is almost always based on a reconstruction of mark-up percentages. The Court of Cassation examined the case of a pharmacy whose mark-up on prescription medicines alone the tax office had reconstructed using the simple arithmetic mean over a sample of products (judgment 22432/2016). According to the Court, the simple mean is acceptable when the products are homogeneous in value and mark-up, and it is for the taxpayer to show that they are not and that the best-selling items have lower mark-ups. The pharmacy also lost because the objection had not been raised in the initial appeal.

A pharmacy’s arguments are stronger than those of an ordinary shop, but they must be documented. Reimbursed medicines have prices and remuneration set by law, and an ‘average’ mark-up on them makes no sense; parapharmaceutical products have higher mark-ups but weigh less in turnover. An average that ignores this mix can be challenged only if the pharmacy can produce management software data by category, the DCRs and the reconciliations. Since 2024 the tax office must hold a contraddittorio preventivo (mandatory prior consultation with the taxpayer) (Article 6-bis of Law 212/2000): that is when this evidence must be presented. The second weak point is stock: unexplained stock discrepancies, expired products without a waste form, free goods not loaded into stock, DPC medicines that have ended up in stock.

Worked examples: accounting entries and tax calculations

The rules in the previous chapters are best measured against figures. Here we follow an imaginary pharmacy, but one built on values we often find in the sector’s accounts: a business with revenue of about two million euros, recently bought with a bank loan, with six employees and a large share of sales under the health service agreement. First we record in double entry the transactions that set it apart from an ordinary shop: ventilazione, the DCR, DPC, stock, the acquisition, wholesalers’ bonuses and payroll. Then we take the same profit and tax it under the legal forms that the law allows for owning a pharmacy, to see how much is really left for those who work in it.

References are to the rules in force in 2026 (TUIR, Presidential Decree 633/1972, Legislative Decree 446/1997). From 1 January 2027 the new consolidated Acts change the numbering of many articles, not the mechanisms illustrated. In every entry total debits equal total credits; summary amounts are rounded to the nearest euro.

The model pharmacy and the starting assumptions

The pharmacy is urban, located in Emilia-Romagna, with ATECO code 47.73.10. A pharmacist bought it as a business on 2 January 2026 for €2,000,000, of which €1,600,000 was financed by a bank loan. The owner works at the counter and directs the pharmacy; the owner’s spouse is also a pharmacist. The premises are rented from a private landlord.

With these figures revenue is €2,004,759, the cost of sales is €1,353,150 (purchases of €1,350,000 plus the decrease in stock of €3,150) and the gross margin on goods is 30.4%. EBITDA, before depreciation, amortisation and interest, is €275,048. Profit before taxes and before any remuneration of the owner or shareholders is €98,148. It is a profit squeezed by the first year of debt: goodwill and interest absorb €162,900 of it.

1. Counter takings and ventilazione

Counter sales are certified by the online cash register with the code ‘VI’ instead of a rate, and are recorded without distinguishing the tax. The breakdown by rate is made on the basis of purchases of goods intended for resale (Article 24, third paragraph, of Presidential Decree 633/1972 and Ministerial Decree of 24 February 1973), progressively during the year and with an adjustment based on the figures for the whole year.

This raises the choice mentioned in the part on accounting: what to do with SSN takings. In the example we record them separately, at 10%, because the rate for the supply to the national health service is certain (reply to request for legal advice No. 5/2025) and because on that part VAT becomes chargeable when the ASL pays (point 2). For consistency we remove from the ventilazione base the cost of medicines supplied under the health service agreement. We derive it from the DCRs themselves: the share due to the manufacturer (66.65%) and to distribution (3%) is worth, in our example, 77.40% of SSN consideration, that is €588,264 out of €760,000. The criterion is not set out in any official guidance: it is a choice we consider defensible because it rests on documentary and repeatable data, and it must be described in the working papers and kept constant.

Net counter revenue is therefore €1,184,759.04. If instead counter and SSN takings (€836,000 including VAT) were apportioned together on the basis of total purchases, total VAT would be €237,570.56 against €241,240.96 under our method (€165,240.96 on the counter plus €76,000 on the SSN): €3,670.40 less. The difference arises because ventilazione assumes the same mark-up on everything, whereas a medicine supplied under the health service agreement has a regulated margin (22.6% of consideration in the example in point 2) and a parapharmaceutical product at 22% a much higher one. The single method is lawful and widespread, but it shifts tax from 22% to 10%: anyone who adopts it should know that an audit conducted on margins will see it.

During the year ventilazione is applied using the progressive purchase percentages. In March, with counter takings of €112,500 and progressive percentages that we assume to be equal to the annual ones, the month-end entry and the VAT settlement are as follows:

Output VAT in the settlement includes, in addition to the €13,770.08 apportioned, €472.73 on the month’s prescription charges, €6,006.07 on the January DCR paid by the ASL in March (point 2) and €396 on services at 22%. Input VAT is the VAT on the month’s purchases: €64 on products at 4%, €8,600 at 10%, €5,060 at 22% and €880 on overheads. VAT on DPC invoices does not appear, because it is paid over by the ASL (point 3). At year end the calculation is repeated on the purchases for the whole year and the difference from the sum of the months is recorded as an adjustment.

2. The monthly DCR

Take the March DCR: 6,000 packs dispensed under the health service agreement, for a total retail price of €72,000 net of VAT. Under the remuneration in force since 1 March 2024 (Article 1(225) to (227) of Law 213/2023) the pharmacy’s consideration from the SSN is made up as in the Agenzia’s reply No. 5/2025: manufacturer’s and distribution shares, the 6% variable fee and the fixed fee per pack, all at 10%. Price bands and quantities are assumptions.

The pharmacy’s margin on this DCR is €14,640 (variable fee, fixed fees and transparency fee), 22.6% of consideration. For VAT purposes pharmacies have always followed a rule whose source is often forgotten: for supplies of medicines in item 114 of Table A, Part III, made by pharmacists, the tax becomes chargeable when the consideration is paid (Article 6, fifth paragraph, second sentence, of Presidential Decree 633/1972). Prescription charges are paid immediately, and their VAT goes into the month’s settlement; VAT on the part borne by the ASL waits for the bank transfer.

SSN revenue for the month is €64,788 (4,727.27 + 60,060.73) and belongs to the month of dispensing, even if the ASL pays later (point (a) of Article 109(2) TUIR). The nature of the deductions must be read in the DCR: the owner’s ENPAF contribution is not a cost of the business but a personal pension charge, which in a sole proprietorship goes through drawings and is deducted in the owner’s tax return; in a company it is charged to the shareholder.

If the bank transfer arrives forty days after the due date, DCR receivables do not carry the enhanced late-payment interest under Legislative Decree 231/2002 (Cass., Joint Divisions, 20 November 2020, No. 26496, referred to in the chapter on dealings with the health service), but interest at the statutory rate, which in 2026 is 1.60% (Ministerial Decree of 10 December 2025): 66,066.80 × 1.60% × 40/365 = €115.84. It is rarely claimed, but if collected the entry is Bank to Late-payment interest income for €115.84, outside the scope of VAT (Article 15, first paragraph, point 1, of Presidential Decree 633/1972), and it is taxable only in the year in which it is received (Article 109(7) TUIR).

3. DPC: the invoice for the service to the ASL

During the month the pharmacy hands over 500 packs under DPC. The medicine belongs to the ASL and does not enter stock; the pharmacy invoices the service. In the example the fee under the regional agreement is €5 per pack (an assumption), with VAT at 22% and split payment (Article 17-ter of Presidential Decree 633/1972), according to the prevailing approach; some regional agreements structure the flow differently, and the rate must be checked against the agreement.

The invoice is entered in the sales register but does not enter the settlement. On €30,000 of annual DPC fees the pharmacy does not collect €6,600 of VAT: with high volumes of DPC the VAT balance shifts towards a credit, and the annual credit must be used by set-off or claimed as a refund.

4. Stock: two methods compared, expired products

At 31 December the physical stock count shows goods worth €300,000 at selling price net of VAT. The management software, which values each product line at its latest purchase cost (FIFO), gives €208,400; at the weighted average cost for the year it gives €206,100. Under the retail method the starting point is the price, from which the category’s margin is deducted:

The same stock is therefore worth €203,850 at retail price by category, €206,100 at average cost and €208,400 under FIFO. If a single margin were applied, the pharmacy’s average margin on goods (30.4%, lowered by the weight of medicines supplied under the health service agreement), the value would rise to €208,800. Between the lowest and the highest method there is €4,950 of income, which for a sole owner in the 43% band is worth about €2,330 in IRPEF and surcharges. OIC 13 allows the retail method for retailers when it approximates cost; for tax purposes the schedule explaining criteria and categories is required (Article 92(8) TUIR), without which the tax office may reassess the difference from the ordinary criteria. Once a method is chosen, it must be maintained over the years.

During the year products costing €3,900 expired. With a periodic stock count no write-off entry is needed: the cost is already in purchases and the products do not appear in closing stock. What is needed is proof that they were destroyed and not sold: the authorised operator’s waste identification form, or the advance notification to the offices and the record of destruction, which for goods costing no more than €10,000 may be replaced by a statement in lieu of an affidavit (Article 2 of Presidential Decree 441/1997). With that documentation the VAT deducted on purchase is not adjusted and no output VAT arises. The only entry is the cost of the disposal service: Waste disposal services 240 and Input VAT 52.80, to Suppliers 292.80.

5. The purchase of the pharmacy

The price of €2,000,000 is allocated in the deed: €1,720,000 to goodwill, €80,000 to furniture and equipment, €200,000 to goods. No liabilities are assumed, and the TFR accrued by employees is settled between the parties within the price (an assumption). The sale is outside the scope of VAT (point (b) of Article 2, third paragraph, of Presidential Decree 633/1972) and is subject to 3% registration tax on goodwill and movable assets: €60,000. The notary costs €10,000 plus VAT. The ancillary costs, €70,000, are allocated to the assets in proportion to the price: €60,200 to goodwill, €2,800 to furniture, €7,000 to goods.

The loan is for fifteen years at 4%, with equal annual instalments of €143,905.76 (an assumption). The buyer contributes €472,200 of his or her own funds, plus the VAT on the notary’s fee, which is recovered.

The goodwill recognised is €1,780,200. For tax purposes it is deducted at no more than one eighteenth a year (Article 103(3) TUIR), that is €98,900, and the same applies for IRAP. In the financial statements OIC 24 requires it to be amortised over its useful life, up to twenty years if the useful life can be estimated, over ten years if it cannot. For a pharmacy, whose value lies in an ownership right that does not expire, a useful life of eighteen years is easily justified in the notes to the financial statements, and this is the solution we use, so that the financial statements and the tax return coincide. If instead goodwill were amortised over ten years in the financial statements (€178,020 a year), only €98,900 would still be deducted: for ten years there would be an upward adjustment of €79,120, recovered over the following eight years through downward adjustments of €98,900. The reverse is not possible: a tax amortisation charge higher than the book charge is not deductible.

For a pharmacist who is a sole owner, loan interest is deducted in the ratio under Article 61 TUIR between revenue that is taxable and total revenue: in a pharmacy, where all revenue is taxable, in full. For a company the limit under Article 96 TUIR applies, which in the srl example (section 8.4) becomes binding. For IRAP purposes interest is not deductible under any legal form.

The buyer is jointly and severally liable with the seller, up to the value of the business, for taxes and penalties for the year of the sale and the two previous years (Article 14 of Legislative Decree 472/1997). The certificate of outstanding tax liabilities should be requested before the notarial deed and kept in the acquisition file, together with the valuation of goodwill and the check on the 20% regional limit (Article 1(158) of Law 124/2017).

6. Year-end bonuses and free goods from the wholesaler

The contract with the main wholesaler provides for a bonus of 1.5% on purchases for the year if they exceed €850,000. Purchases came to €900,000, all of products at 10%: the bonus is €13,500 plus VAT, credited by a credit note (Article 26 of Presidential Decree 633/1972) issued in February 2027. The bonus accrues in 2026 and reduces the cost of goods for that year.

For VAT purposes, on the other hand, the credit note counts when it is recorded: it will reduce the purchases at 10% on which the 2027 ventilazione is calculated, not those of 2026 (in the table in point 1, for simplicity, purchases are already shown net). A bonus recorded when the credit note arrives, in February, would shift €13,500 of income from one year to another. Amounts paid by manufacturers for window displays, display stands and promotional days are a different matter: they are consideration for a service provided by the pharmacy, are invoiced at 22% and do not reduce purchases.

In the same year the wholesaler delivered, as free goods provided for in the contract, 150 packs of dermocosmetics with a list price of €1,200. Free goods do not form part of the supplier’s taxable amount (Article 15, first paragraph, point 2, of Presidential Decree 633/1972) and give rise to no purchase entry. The packs must, however, be loaded into the management software at zero cost: when sold, they produce full revenue; if unsold, they are in the stock count. Under FIFO they are worth nothing; at retail price they are worth the price less the category’s margin. This is one of the reasons why the two methods in point 4 give different values.

7. The cost of an employed pharmacist and a counter assistant

The agreement is the CCNL for employees of private pharmacies (Federfarma), which expired on 31 August 2024 and had not been renewed at the date of this guide. As we have not been able to check the minimum pay rates against an up-to-date official source, we use rounded figures, to be replaced with those on the payslip. The INPS rate borne by the employer (29%) and by the employee (9.19%), the INAIL rate (0.5%) and the amount of night and public holiday supplements are also assumptions.

Three pharmacists and three assistants cost €243,561, the figure used for the model pharmacy. The bilateral body, supplementary health insurance, supplementary pension and any back pay or one-off payment that the renewal will bring are not included.

The monthly payslip of the pharmacist, with €2,300 of basic pay and €200 of night and public holiday supplements, is recorded as follows. Ordinary IRPEF withholding is the amount calculated by the payroll software (here €380); on the supplements the employer, as withholding agent, applies the 15% substitute tax on €125, one twelfth of the annual cap of €1,500, a prudent allocation chosen for the example and adjusted in December: the law sets only the annual limit.

An employed pharmacist also belongs to a second pension scheme, which the employer does not see: ENPAF. The 2026 contribution is a fixed amount; an employee covered by INPS may apply for the 85% reduction and pay the reduced amount, or pay only the solidarity contribution of €204, which gives no pension cover. It is borne by the pharmacist, not by the pharmacy; if the pharmacy reimburses it by agreement, the reimbursement is taxable pay.

8. The possible legal forms and the pension rules that change the figures

A private pharmacy may be owned by an individual pharmacist, a partnership, a company or a cooperative (Article 7 of Law 362/1991, as amended by Law 124/2017). We compare the same profit of €98,148, before taxes and before remuneration of those running the business, under five arrangements: a sole owner on his or her own; a family business with the pharmacist spouse; an snc (general partnership) between the two pharmacists, 50% each; an srl between the same two, who are directors with a fee; the same srl electing for tax transparency.

The rates and parameters are as follows:

• IRPEF 2026: 23% up to €28,000, 33% up to €50,000, 43% above (Article 1(3) of Law 199/2025).
• Emilia-Romagna regional surcharge 2026: 1.33% up to €15,000, 1.93% up to €28,000, 2.78% up to €50,000, 3.33% above (L.R. 1/2025). Municipal surcharge at 0.8%, as an assumption.
• IRAP: 4.20% (see the box below). Individuals carrying on a business have not paid it since 2022.
• ENPAF 2026: full contribution of €5,430 (€5,388 pension, €31 welfare, €11 maternity), deductible from total income.
• IRES: 24%. The reduced 20% rate under Law 207/2024 concerned the 2025 tax period and does not appear to have been renewed for 2026.
• INPS gestione separata 2026 for a director already registered with another compulsory pension scheme: 24% of the fee, two thirds borne by the company and one third by the director.

We do not consider tax credits for dependants, deductible expenses other than contributions, or other income.

8.1 Sole owner

The owner runs the business alone and does not pay IRAP. From business income of €98,148 the owner deducts ENPAF, arriving at taxable income of €92,718: €32,069 of IRPEF, €2,485 of regional surcharge and €742 of municipal surcharge. With ENPAF the total burden is €40,726, leaving €57,422. The marginal rate, combining IRPEF and surcharges, is 47.13%.

8.2 Family business with the pharmacist spouse

If the spouse works in the pharmacy on a continuous basis and the family business is set out in a notarial deed or authenticated private agreement predating the start of the tax year, up to 49% of the income is allocated to the spouse (Article 5(4) TUIR). The pharmacist spouse pays into ENPAF, not INPS.

The total burden is €36,534, leaving €61,614. Compared with the sole owner, €9,622 less tax is paid and there is one more ENPAF contribution, which does, however, build a second pension. The comparison is valid only if the spouse’s work is genuine: if the spouse does not work in the pharmacy, there is no family business. The alternative, hiring the spouse as an employee, is the least favourable: the spouse’s pay is not deductible from the owner’s income (Article 60 TUIR), while the contributions are still paid.

8.3 Snc between two pharmacists

The income is allocated to the partners on a tax-transparent basis (Article 5 TUIR), but the partnership pays IRAP. The base starts from the value of production, which does not deduct interest; the cost of permanent staff is fully deductible (Article 11(4-octies) of Legislative Decree 446/1997) and a partnership is entitled to the standard deduction of €8,000 increased by €5,000 (paragraph 4-bis), because the base does not exceed €180,759.91.

10% of IRAP is deducted from income (Article 6 of Decree-Law 185/2008), €626: this leaves €97,522, €48,761 per partner. Each deducts ENPAF and on €43,331 pays €11,499 of IRPEF, €877 of regional surcharge and €347 of municipal surcharge. The total burden is €42,570, of which €6,264 is IRAP, leaving €55,578. If the Court of Cassation’s view on the traders’ scheme were to prevail for snc partners too, each partner would owe about €11,944 more in INPS contributions, partly offset by their deductibility.

8.4 Srl between two pharmacists

The two shareholders are directors, each with a fee of €30,000. Gestione separata contributions are due on the fee: according to INPS, even if the director is a pharmacist, because the office of director is not the same as the professional activity covered by ENPAF. At 24% they amount to €14,400, of which €9,600 is borne by the company. Fees and contributions are not deductible for IRAP purposes.

Each shareholder has taxable income of €22,170 (€30,000 fee, less €2,400 of gestione separata contributions and €5,430 of ENPAF). Gross IRPEF is €5,099; the tax credit for income treated as employment income (Article 13(1) TUIR) is €2,012 (€1,947 plus the €65 increase under paragraph 1.1), because it is calculated on total income of €27,600, which deductible expenses such as ENPAF do not reduce. Net IRPEF falls to €3,087. The surcharges are €338 regional and €177 municipal.

The total burden is €50,053: €6,474 of IRAP, €7,264 of IRES, €14,400 of gestione separata contributions, €10,860 of ENPAF, €7,204 of IRPEF and surcharges, €3,851 of withholding tax on dividends. This leaves €48,095. If the profit stays in the company to repay the loan, the withholding tax is deferred until distribution.

8.5 Srl with tax transparency

The election under Article 116 TUIR is allowed because the shareholders are two individuals and revenue is below the statutory threshold; it lasts for three years and binds all shareholders. The company pays IRAP (€6,474) but not IRES, and its income, €30,267, is allocated to the shareholders at €15,133.50 each. Each has taxable income of €37,303.50, pays €9,510 of gross IRPEF, has a tax credit reduced to €631, calculated on total income of €42,733.50, and net IRPEF of €8,879, plus €709 regional and €298 municipal surcharge.

The total burden is €51,506, leaving €46,642: more than the ordinary srl. The allocated income is added to the fee, moves into the 33% band and cuts the tax credit on the fee. Profits from the transparency years, when distributed, are not subject to the 26% withholding tax, because the shareholders have already been taxed on them, and they are reported in form 770, section SK.

8.6 Companies with non-pharmacist shareholders

Since 2017 people who are not pharmacists, and companies, may also be shareholders in a company that owns a pharmacy, with direction entrusted to a pharmacist and within the limits on incompatibility and the 20% regional concentration limit (Article 7 of Law 362/1991).

Three things change. The pharmacist director, if not a shareholder, is an employee with his or her own cost and pay for the role. A non-pharmacist shareholder who works in the pharmacy falls within the INPS traders’ scheme, with contributions proportional to income. A corporate shareholder is taxed on only 5% of dividends (Article 89(2) TUIR), provided the holding is at least 5% or has a tax value of at least €500,000 (paragraph 2.1, introduced by Law 199/2025), that is at an effective rate of 1.2% with IRES at 24%, and may sell the shareholding with the exemption under Article 87 TUIR if the requirements are met. This is the structure used by investors and chains, and the natural vehicle for bringing in an investor shareholder when the pharmacy needs to finance a second outlet.

8.7 The comparison

At this level of profit the lightest form is the family business: it pays no IRAP, splits income across two tax bands and pays fixed contributions. The snc pays the same IRPEF plus IRAP, and is the natural form when the two pharmacists are not spouses or when both are to be owners in their own right. The srl loses on three fronts: IRAP, gestione separata contributions on fees and the limit on interest. Transparency does not improve the result with fees of this size.

The picture shifts as profit grows, for example once the loan is repaid or with a second outlet. In a sole proprietorship every euro of taxable income above €50,000 pays 47.13% in IRPEF and surcharges; in an srl retained profit pays 24% plus IRAP, and 26% only when distributed. To repay acquisition debt, or to build up funds for an investment, money taxed at 24% is lighter than money taxed at 47%. The comparison must be redone on the pharmacy’s actual figures, over several years, together with the questions of who should be able to join the company and how the owners will eventually exit the business.

8.8 The exit: selling the pharmacy

Suppose that after twelve years the pharmacy is sold for €2,500,000: €2,300,000 for goodwill and furniture, €200,000 for goods at their book value. The residual tax cost of goodwill is €593,400 (€1,780,200 less twelve annual charges of €98,900); the furniture is fully depreciated. The capital gain is €1,706,600. The outstanding loan, about €399,000, is repaid out of the price and does not change the tax figures.

For an individual pharmacist, separate taxation under Article 17 is claimed in the tax return, in section RM, if the business has been held for more than five years; the Agenzia then calculates the final tax. For those who have inherited, the five-year period is added to that of the deceased (Cass. No. 4444/2022). It is not available to an snc: the partnership’s capital gain enters the ordinary income allocated to the partners, with only the option of spreading it under the conditions of Article 86. An srl has no separate taxation, but may spread the gain; if instead the shareholders sell their shares, the capital gain on the shareholdings is taxed at 26%, and the buyer loses the amortisation of goodwill, which is usually reflected in the price. Anyone thinking of exiting within a few years should look at this table before choosing the legal form under which to enter.

8.9 The receipt the patient needs

A patient spends €900 a year on medicines, all with an itemised receipt showing his or her tax code. The 19% tax credit is calculated on the part exceeding the €129.11 threshold (point (c) of Article 15(1) TUIR): (900 − 129.11) × 19% = €146.47. For medicines and medical devices bought in a pharmacy, payment may also be made in cash (Article 1(680) of Law 160/2019).

A note on the examples

The examples are simplified. They do not take into account tax credits for dependants and other income, the actual rate of the municipal surcharge, the INAIL rate actually applicable to the pharmacy, CCNL minimum rates after renewal, the 0.50% contribution that reduces the TFR accrual, cash-basis deductibility of IRAP paid, payments on account and deferred taxes. The criterion for adjusting the ventilazione base, the DCR shares, the DPC fee and the margin percentages are assumptions built for the example. The legal form, the stock valuation method and the treatment of SSN takings must be chosen on the basis of the individual pharmacy’s figures, with a multi-year simulation that also covers the exit.

Dealings with the health service, local health authorities, municipalities and patients

The health service agreement

Pharmacies dispense medicines paid for by the national health service under a national collective agreement (Article 8(2) of Legislative Decree No. 502 of 30 December 1992). After an agreement that had remained in force since 1998, a new one was agreed in the State-Regions Conference on 6 March 2025. Regional agreements set out the operational aspects, including DPC and remuneration for services. In Emilia-Romagna supervision of the application of the agreement and the payment of amounts due are the responsibility of the Azienda USL (Article 11 of L.R. 2/2016).

Receivables from local health authorities and interest

Legislative Decree No. 231 of 9 October 2002 sets a payment term of sixty days for health service bodies and late-payment interest at the enhanced rate. For a pharmacy’s DCR receivables, however, that route has been closed: the Joint Divisions of the Court of Cassation (judgment No. 26496 of 20 November 2020) held that dispensing Class A medicines is not a commercial transaction, because in that activity the pharmacist is part of the national health service and the relationship is governed by law and by the health service agreement. Statutory interest, not the enhanced rate, is due on late payment. The judgment concerned the text of the decree before the 2012 amendments, but later courts have read the principle in general terms.

The position of receivables for services provided on a contractual basis, such as DPC or the services of the pharmacy of services, is different and less explored: here the classification must be based on the legal basis of the claim. Those facing significant delays should prepare a formal letter of demand and an application for a payment order (decreto ingiuntivo) that distinguish between the items, instead of applying the same rate to everything.

Health data and the electronic health record

Every day a pharmacy processes data concerning health, which are special categories of data under Article 9 of Regulation (EU) 2016/679. Processing necessary for dispensing does not require consent, but it does require appropriate measures: confidentiality at the counter, role-based access to the management software, prescriptions not left in view, written instructions to staff. The pharmacy feeds the electronic health record (Article 12 of Decree-Law No. 179 of 18 October 2012) and, with services and telemedicine, processes further data that require specific privacy notices and, when external providers are used, their appointment as data processors. For home deliveries L.R. 2/2016 (Article 15) expressly refers to data protection and to the prescription being processed in the pharmacy before delivery.

Cash and anti-money laundering

A pharmacy is not among the entities required to carry out customer due diligence under Legislative Decree No. 231 of 21 November 2007, but like anyone else it is subject to the limit on cash transfers: cash payments must remain below €5,000 (Article 49 of Legislative Decree 231/2007). At the counter the issue rarely arises; it does arise in dealings with suppliers, in the sale of the business or of shares and in repayments between shareholders.

Compliance model and comparaggio

For companies that own pharmacies it makes sense to consider an organisational model under Legislative Decree No. 231 of 8 June 2001. Dealings with the national health service carry typical risks, such as fraud against a public body, and the model is what protects the company from liability for an offence committed by an employee or director. Comparaggio (Articles 170 to 172 of the consolidated Act on health laws) should also be borne in mind: it punishes doctors and pharmacists who receive money or other benefits for promoting the use of proprietary medicines, and those who give or promise them. Arrangements with prescribers, ‘collaborations’ with doctors’ surgeries in the same building and sponsorships should be assessed with this rule in mind.

The Comune

In Emilia-Romagna the Comune does not merely approve the pianta organica. It authorises openings, recognises ownership, authorises relocations of premises, moves to new residential areas and transfers between pharmacists, declares forfeiture and orders temporary closure (Article 10 of L.R. 2/2016); it sets minimum opening hours and may regulate the arrangements for night duty. When it runs its own pharmacies it is also a competitor. Complete, documented applications avoid most disputes, and when a dispute does arise the quality of the file built up beforehand makes the difference before the TAR.

Patients

The law guarantees citizens a free choice of pharmacy (Article 15 of Law 475/1968). When the doctor has not indicated that the medicine may not be substituted, the pharmacist, after informing the patient and unless the patient asks otherwise, supplies the lowest-priced equivalent medicine (Article 11(12) of Decree-Law 1/2012), and must enable citizens to distinguish healthcare products from commercial ones (Article 17 of L.R. 2/2016). These are simple rules. A complaint deserves a written, traceable reply: it is a sign of respect for the patient and, if the complaint reaches the local health authority and leads to an inspection, also the best evidence of how the pharmacy works.

Grey areas

Some questions do not yet have a settled answer. We set them out here with the solution that, in our view, exposes the owner least.

Three questions already discussed

Three conflicts have been dealt with in earlier chapters and we simply recall them here. For the heirs of a sole owner, the one-year period in Article 12 of Law 475/1968 coexists with the six months from the inheritance tax return in Article 7(10) of Law 362/1991: we consider the latter to prevail, but both should be counted and the earlier one met. For a pharmacist shareholder who works in the pharmacy, the 2010 INPS note and the 2012 Court of Cassation decision say opposite things: the risk of contributions to the traders’ scheme should be estimated before deciding how to remunerate the shareholder. For DPC the rate follows the regional model: 22% with split payment if it is a service, 10% if it is a resale of medicines.

Vaccinations, telemedicine and new services

The extension under Law 182/2025 was not accompanied by any VAT clarification. For services provided by qualified healthcare professionals for the purpose of protecting health the exemption is defensible; for self-monitoring tests and administrative services it is not. In borderline cases involving modest amounts, treating the service as taxable avoids disputes.

Leasing the business of a private pharmacy

For municipal pharmacies management may be entrusted to third parties; for private pharmacies Article 12 of Law 475/1968, which ties the right to operate to the business and requires the transfer to be recognised, makes leasing the business a transaction to be checked with the health authority before any tax analysis. If it is allowed, the ordinary rules apply (rents subject to VAT if the lessor remains an entrepreneur, depreciation by the lessee unless otherwise agreed, Article 102(8) TUIR) and, on the employment side, Article 2112 of the Civil Code as already discussed.

Interest on receivables for services and DPC

The Joint Divisions excluded late-payment interest under Legislative Decree 231/2002 for dispensing Class A medicines; for DPC and service receivables the question is open. A formal letter of demand should apply the enhanced interest only to items that are contractual in nature, in the knowledge that the point may be disputed.

Withholding tax on the residence allowance and cohabiting partners in a family business

Specialist commentators have argued that the 4% withholding tax on the residence allowance is not due, without official confirmation: those who suffer it should credit it. On allocating income to a cohabiting partner who takes part in a family business, following Constitutional Court judgment No. 148/2024, the Agenzia has not yet taken a position: it is not advisable to base any planning on it.

What to do

Before buying a pharmacy or joining a company

1. Check the ownership decree, the area in the pianta organica, any reviews in progress and disputes over the premises; for companies formed after the extraordinary competition, the opening date and the history of the shareholder base.
2. Check the buyer’s requirements and the incompatibilities of all shareholders, tracing the chain of shareholdings, and the 20% limit on a regional basis.
3. Choose between buying the business and buying the shares, calculating the tax effects on goodwill, interest and future resale.
4. Request the certificate of outstanding tax liabilities; allocate the price among categories of assets in the deed.
5. Carry out employment due diligence: job grades, TFR, holidays, self-employed pharmacists, DVR; specify in the contract who bears accrued liabilities.
6. Align payroll, UNILAV notifications and the libro unico with the date on which the transfer is recognised, not the date of the notarial deed; notify changes to the articles of association and the shareholder base within sixty days.
7. Notify the pairing of card terminal and cash register for new terminals and arrange the correct pension and social security registrations for each shareholder.

During the year

1. Every day: cash-up for each till, reconciled with the card terminal.
2. Every month: reconciliation of the DCR with SSN takings, the bank transfer and deductions, disputing charges within the time limits; DPC and supplementary care invoices issued and collected net of VAT under split payment; progressive ventilazione; check of night, public holiday and on-call supplements on payslips.
3. For every new medical device or supplement product line: a rate documented by the supplier and consistent with the customs classification.
4. By 31 January: transmission to the Sistema TS of the previous year’s expenses, with customers’ objections.
5. By February in even-numbered years: follow the start of the review of the pianta organica and prepare observations; by 31 March: holiday calendar set by the Azienda USL.
6. March, April and September: pharmacists’ ENPAF instalments, with any applications for reductions.
7. Within the ordinary deadlines: VAT return, income tax and IRAP returns with the ISA form; check of the two ventilazione limits for the following year; pro rata calculation if there are exempt services.
8. By the opt-in deadline: review of the concordato preventivo biennale proposal.
9. In December: year-end adjustment with the 15% and 5% substitute taxes for 2026; planning of hires qualifying for incentives; update of the DVR and medical checks for night workers.
10. At 31 December: signed physical stock count, schedule of criteria if the retail method is used, documentation of expired stock disposed of, reconciled receivables from local health authorities, suppliers’ bonuses on an accrual basis, DPC excluded from closing stock.
11. To be kept for an audit: DCRs and reconciliations, DPC agreements, waste forms for expired stock, theft reports, count sheets, documentation of reduced rates, internal policy, contracts and calendars of self-employed pharmacists.

What the firm does for pharmacies

In a pharmacy, accounts, payroll and the rules of the service cannot be separated. A misread line in the DCR changes the financial statements; a self-employed pharmacist with the keys to the pharmacy becomes an employee; an inheritance tax return filed without a plan starts a six-month time limit that nobody has calculated.

We assist sole owners and companies with accounting and VAT, with or without ventilazione, the monthly reconciliation of DCRs and bank transfers, stock and financial statements. We process payroll under the sector agreements and duty rotas, and put in order the pension and social security registrations of owners, shareholders and family members. We assist with acquisitions, the choice of legal form, the entry of new shareholders and the handover to the next generation, keeping tax, authorisations and employment together, and with tax audits and inspections.

We know that the owner spends the day at the counter and that time for paperwork comes in the evening or on closing days: we ask for documents only when we really need them. When an owner dies, the first task is to set out deadlines and options in order, so that the family can choose with the figures in front of them and not under the pressure of time limits. The firm’s offices are in Codigoro, Ferrara and Milan.

This guide is for general information only and does not constitute professional advice on any specific case, which requires an examination of the documents and the specific facts. The content is up to date as at 16 October 2026; subsequent legislation, administrative practice and case law may alter its conclusions.

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