Auditor General: Pharmacy reform required more effort

Independent Paekivi pharmacy owned by Andre Vetka
Independent Paekivi pharmacy owned by Andre Vetka Source: OÜ Marja Apteek

Estonia's Auditor General Janar Holm said the Ministry of Social Affairs should have done a better job at preparing the pharmacy reform, newspaper Postimees reported.

The daily reported that the pharmacy reform partially stemmed from a 2012 audit of the National Audit Office, which concluded that medicinal products in Estonian pharmacies are sold at higher prices than in many other countries and patients' own contribution when buying pharmaceuticals is among the highest in Europe.

The audit cited insufficient competition between wholesalers of medicinal products as reason for this, and recommended for the Ministry of Social Affairs to separate pharmaceutical wholesalers from pharmacies to ensure that the latter can freely order their products from multiple wholesalers, not just its owner.

"We didn't specifically say in the audit that pharmacies should be owned by pharmacists. We spoke about dismantling vertical integration, which, admittedly, would have been fulfilled in this way," Holm said.

The National Audit Office's main criticism is that a reform this complex will not implement itself. 

"It needs a lot of work. I think the Ministry of Social Affairs has started handling this reform a little late. However, it's not the twelfth hour yet, it's more like the eleventh hour, and reforms like this are usually born at the last moment anyway," Holm said. 

Key events in such reforms generally take place a month or two before the reform actually takes effect.

"I think it's worth a try to continue implementing this reform, but it'll take more effort. The confidence of both the society and members of the Riigikogu needs to be boosted to assure them that nothing bad will happen when April 1, 2020, arrives. And this is where the Ministry of Social Affairs has a lot of work to do," the auditor general said, adding that during the five-year transition period, the ministry should have taken much more action.

"As far as we know, the Ministry of Social Affairs promised to carry out an impact analysis several years ago. Where is this impact analysis? There is none. No one else to blame for it but the Ministry of Social Affairs, either. What needs to be done now is that this reform simply has to be taken forward at a more rapid pace while encouraging confidence in some other way. There is much more at stake with this bill than just the issue of pharmacies - trust in long-term plans actually getting realized, for instance," Holm said.

Janar Holm. Source: (Kaarel Tooming)

The planned reforms had been slated for April 1 2020, but met with strong opposition from major pharmacy lobby groups in particular. The bill had aimed to place control of pharmacies firmly in the hands of qualified pharmacists, rather than chains; critics claimed that the reforms would have spelled the death knell for pharmacies in smaller towns and rural areas.

Research also showed that in reality, very few pharmacies met the requirements of the proposed reforms.

Last week a bill seeking to amend the Medicines Act was submitted to the Riigikogu featuring changes which would abolish the new reform's rules around pharmacy ownership.


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Editor: Helen Wright

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