The analysis of competition policy shows that the full-service pharmaceutical wholesale trade operates in an extremely competitive market environment. In particular, this competition focuses on the parameter of price and sometimes takes on ruinous features. Due to specific market conditions on the supply and demand side (so-called market failure), pharmaceutical wholesalers cannot effectively free themselves from this competitive dilemma on their own. As a result, the companies could foreseeably no longer be able to ensure the viability of their business operations in the way required by the statutory mandate to ensure and provide supply. In this respect, there is a high public interest in shaping the economic framework conditions in such a way that functional competition can develop. In this way, efficient and sustainable structures can ultimately be guaranteed to ensure a nationwide supply of medicines via and through the full-service pharmaceutical wholesale trade. A need for action in health and economic policy can therefore be derived directly from the analysis carried out.