Business as usual for pharmacies despite impending reforms

Locations across Estonia which don't currently have a pharmacy which complies with the new law coming into effect April 1.
Locations across Estonia which don't currently have a pharmacy which complies with the new law coming into effect April 1. Source: ERR

The pharmacy sector in Estonia seems to be active, even hiring plenty of new staff, despite uncertainty surrounding the planned government reforms for April 1.

At stake has been a conflict between big business pharmacy wholesalers and their related chains – the latter more familiar to readers as outlets like Apotheka and Benu – and qualified, dispensing pharmacists, many of whom have decades' experience.

The move towards control of the sector being passed to dispensing pharmacists, giving them 51 percent or more stakes in the pharmacies they work at, and effectively transforming them into small business people, was on the table five years ago.

The large wholesalers, including Magnum Medical, owned by businessman Margus Linnamäe, have been lobbying hard to get the law overturned. In December a bill to do just that was defeated at the Riigikogu after the coalition had scrapped the original reform plans; this put things at least on paper back on track.

However, all the upheaval does not seem to be reflected in the day-to-day operations of pharmacies themselves, who are still hiring new staff and have not been implementing the requirements the April 1 reforms call for, according to a report on ETV current affairs show "Aktuaalne kaamera" Thursday evening.

Whether the date of the new law coming into force is intentional is another matter.

Since December, the number of pharmacies which qualify for pharmacist ownership, or are already pharmacist-owned, has increased by just one, to 181. This leaves a further 317 pharmacies which do not and which should, if the law were to be followed, close on April 1.

"The recruitment of new employees is very active," says Kaidi Sarv of the Estonian Association of Pharmacists (EAL), which represents dispensing pharmacists.

"Looking at job vacancy portals, pharmacists and pharmacies are search terms across Estonia, which also suggests no widespread closure plans, and in all likelihood that these pharmacies will continue to operate. No lay-offs have been reported either. At this point in time, the State Agency of Medicines (Raviamet) has not been notified of a single pharmacy being closed as a result of the impending reforms," she added.

This is even more apparent considering the law would require pharmacists with more than 10 years' experience being given three months' notice of dismissal, which would mean those due for redundancy should have been notified by January 1, Sarv said.

Not clear what big-chain pharmacies plans are yet

As to the big pharmacy chains' plans, these were still shrouded in mystery, Maris Jesse, deputy secretary general of health at the Ministry of Social Affairs.

"By mid-December, the ministry was prepared for the implementation of pharmacy reform along current lines, dated for implementation April 1," Jesse said.

The ministry, together with the State Agency of Medicines, has mapped the areas which currently only have non-compliant (with the April 1 law) pharmacies, and which in theory would be left without any pharmacies after that date. These mainly concern smaller settlements – an argument put forward by opponents of the reforms said that these areas would suffer most.

The towns and villages are spread evenly across Estonia (see map) and are:

Kose, Kuusalu, Laulasmaa, Loksa, Muraste, Paldiski and Saku (Harju County); Emmaste, Kärdla and Käina (Hiiumaa); Aseri, Avinurme and Kohtla-Järve (Ida-Viru County); Väätsa (Järva County); Kullamaa and Lihula (Lääne County); Haljala, Kadrina and Võsu (Lääne-Viru County); Liiva (Muhu island); Paikuse and Uulu (Pärnu County); Räpina (Põlva County); Vana-Vigala (Rapla County); Rõngu (Tartu County); Otepää, Sangaste, Tõrva and Valga (Valga County); Jämejala, Kõpu, Kolga-Jaani, Mustla and Võhma (Viljandi County).

Jesse added that circumstances vary from region to region, so solutions need to be on a case-by-case basis.

"There are pharmacies that are 100 percent owned by a drug wholesaler, as well as places where the pharmacy has a majority stake in a pharmacist, but the wholesaler is a minority shareholder," she said, adding that in some cases, a dispensing pharmacist is lined up for April 1, and others not.

An additional factor is where wholesalers are giving up ownership in favor of a dispensing pharmacist, the former want to retain control until the eleventh hour.

The original "Aktuaalne kaamera" slot (in Estonian) is here.

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Editor: Andrew Whyte

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