On the eve of a planned pharmacy reform that would see changes made to the Medicinal Products Act, traders have seized their opportunity and submitted a proposal to the coalition's working group according to which nationally approved OTC drugs would be allowed to be sold in regular retail stores.

The EKL is of the opinion that even the partial permission of OTC drug sales outside of pharmacies would help improve access to drugs, reduce the concentration of the wholesale and retail drug market, and encourage price competition in the retail sale of drugs. Retailers believe that this move would relieve restrictions on entrepreneurial freedom and free choice in the field.

"Allowing the retail sales of OTC drugs would not be a threat to anyone," the EKL said in its letter to the pharmacy reform work group, noting that there have been almost no OTC drug-related incidents to speak of in other EU country where their general retail sale is permitted. OTC drugs are sold in regular stores and even in some gas stations in more than half of EU member states.

Store owners find that this change would improve drug access, especially in the evenings and on weekends as well as in rural areas, as even the few 24-hour drugstores that do exist are only located in Estonia's bigger cities. Being able to sell OTC drugs would also help rural stores stay afloat as well.

Competition, meanwhile, would help drive down OTC drug prices, and simpler concerns such as headaches and colds would see faster relief.

Traders found that consultations regarding OTC drugs are equally as accessible via e-pharmacies as they are at retail stores, and besides, OTC drugs are rung up at regular pharmacies by sales associates, not pharmacists.

"Cashiers don't pay attention to what you pull off the shelf and put in your shopping cart," the EKL said. "You can only talk to a pharmacist if you are buying a prescription drug or ask to speak to one on your own initiative."

Should someone buy OTC drugs from the store, the consumer would always have the opportunity to call the family doctor hotline for advice regarding their use, the association added.

Lithuania made the switch to this approach recently. Both Lithuania and Ireland, for example, have gone the route of allowing a limited selection of OTC drugs to be sold at retail stores, in small packs sold to customers one at a time. These products may not be advertised or displayed on store shelves; they can only be purchased directly at checkout.

In Sweden, 15 percent of OTC drugs are sold at regular retail stores, with pain relievers and fever reducers accounting for more than half. Nicotine patches, cold medications and stomach relief meds.

According to the EKL, other countries' experiences have demonstrated that the retail sale of OTC drugs has not reduced the number of pharmacies in rural areas. Store owners also noted that it is pharmacies that have increasingly encroached on retail stores' territory as the former has increasingly begun selling food supplements, herbal teas and other items that are not drugs, thus increasing competition on the market.

The EKL finds that the the State Agency of Medicines, for example, could be the one to decide which OTC meds would be permitted to be sold in stores, taking into account risks, storage conditions and international practice. Stores would order the goods from drug wholesalers, and be responsible for ensuring that packages sold in stores remain unopened and unexpired.

The association suggested that each package could also be labeled with information regarding the family doctor hotline in both Estonian and Russian.

A full opening of the OTC drug market, which would allow for the retail sale of OTC drugs at retail stores and gas stations, is one of several options currently under consideration by the government coalition's pharmacy reform working group.

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