Dozens of pharmacists in rural areas have appealed to the Conservative People's Party of Estonia (EKRE) over planned governmental pharmacy reform, asking for this to remain in place rather than follow a bill EKRE itself tabled.
"EKRE has always stood for the vitality of rural areas, but a bill abolishing the pharmacy reform submitted to the Riigikogu may lead to the closure of pharmacist-owned pharmacies operating in rural areas," the communication read, according to BNS.
The government bill would make mandatory dispensing pharmacists holding a minimum 51 percent stake in the pharmacy they work in. This has been on the table for coming up to five years as per a 2015 act, despite several attempts to reverse course and place pharmacy control back in the hands of the larger wholesalers and their associated chains.
EKRE itself issued a bill recently doing just that, though it also contained provisions for permitting hospitals to run their own retail pharmacies, importing medicines if necessary and not being tied to the local wholesalers.
"The submitted bill will primarily benefit wholesalers and their affiliated chain pharmacies, as the repeal of the reform would result in the concentration of most pharmacies to the possession of two or three major owners. Competition would then increase in particular in the larger cities, where new pharmacies would be opened and the pharmacists currently working in rural areas would simply be bought over in order to gain workforce," the statement continued.
EKRE's bill was matched by a Social Democratic Party (SDE) bill, which would have stuck with the government line – with the reforms due to take effect on April 1 – but phased this in over the course of the year, ostensibly to allow for a softer landing.
Ülle Rebane, chair of the Estonian Pharmacists Association (Apteekrite Liit), one of at least two bodies representing dispensing pharmacists, and manager of the Põltsamaa Uus Apteek pharmacy, one of the over 50 rural pharmacies which issued the EKRE appeal, said that it is pharmacy reform adopted by the Riigikogu five years ago that has ensured the availability of medicinal products in rural areas.
"Restrictions on the establishment of pharmacies in Estonia were introduced in 2006 precisely for the purpose that the pharmacy service would not be concentrated only in larger built-up areas. Prior to the restrictions on the establishment of pharmacies, pharmacies in rural areas were closed down one after the other due to labor shortages. Every new pharmacy in a big city led to the closure of a pharmacy in a rural area," Rebane said. "Over the past five years, it has been namely the pharmacy reform that has kept pharmacies open in rural areas and today, there are over 200 pharmacies with pharmacist participation in Estonia. The repeal of the pharmacy reform would once again cast serious doubt on the future of rural pharmacies," she added.
Mass closures argument now used by both supporters and opponents of government's pharmacy reform
The argument that pharmacy reform would lead to mass closures in rural areas has now been used by both sides of the argment. Opponents of the reforms say that since less than a third of Estonia's nearly 600 pharmacies currently comply wth the ownership requirements, less than two months before the deadline, when April 1 comes, this will mean widespread closures.
The major owners of wholealers, including Magnum Medical and Tamro, which own the Apotheeka and Benu chains respectively, staged a half-day strike – really a lock-in – just before Christmas, in an effort to highlight what widespread closures could look like.
Pharmacists in rural areas also emphasized in their letter to EKRE that their operations should not be considered as business enterprises, but rather as healthcare institutions, despite the requirement in the reforms that they become small businesspeople, in effect.
"It is the pharmacist's job to help address patients' health concerns, rather than focus on maximizing sales and gaining market share. This is all the more so since in many rural areas, the pharmacy is still the only operating healthcare institution," the letter added.
The letter had a total of 53 signatories from 68 pharmacies across the country.
On Friday, Margus Linnamäe, owner of Magnum Medical, said he had thrown the towel in on the ownership requirement, which he would surrender to the dispensing pharmacists come April 1. He said he intended to apply for damages from the state, however.
Editor: Andrew Whyte