Wednesday, April 1 is coming-into-effect date for the government's hotly debated pharmacy reform. A Competition Authority (Konkurentsiamet) spokesperson said that, while in practice pharmacies will be owned by the dispensing pharmacists who work in them from that date, in reality, no seismic change will take place in the sector.
The Competition Authority has in the past been critical of the reforms, which require pharmacists own a minimum 51 percent stake in a pharmacy regardless of prior business experience, and dates back to the Medicines Products Act from five years ago, which made the transition a requirement.
"We still have the same well-known chains on the market, these remain strong, and the pharmacists are still heavily affiliated with the wholesalers. So in this respect, the situation will remain very much the same as before," Competition Authority manager Märt Ots told ETV current affairs show "Aktuaalne kaamera" Tuesday night.
"In the future, no doubt, theoretically, any major player could set up a wholesaler, develop a brand, make franchise agreements; this is possible, but undoubtedly, it will be very, very difficult to implement," Ots added.
The law change met with pushback from the major wholesalers and the pharmacy chains which they operate, namely Magnum Medical, which is responsible for the Apotheka/Terve Pere brand, Tamro, which runs the Benu chain, and Euroapteek.
Magnum owner Margus Linnamäe acquiesced to the reforms – which saw several challenges in late 2019 and early 2020 via a succession of bills aiming to reverse the course, or to modify, the reforms – in early February. All the bills challenging the reforms were voted down in the Riigkogu.
Linnamäe says he will claim damages from the state. The Lithuanian-owned Euroapteek has reportedly set up several companies which will facilitate the pharmacists operating as franchisees.
The reforms faced strong criticism to the effect they would lead to widespread closures, particularly in rural areas; while there have been closures, at least 452 pharmacies in Estonia are compliant with the requirements and will be open on April 1 and going forward.
Under the reforms, a pharmacist-owned pharmacy may be affiliated with up to four outlets in towns of over 4,000 residents.
Watershed town size of 4,000 people
On April 1, 2020, the transition period for pharmacy service to non-pharmacist-owned pharmacies will expire, followed by pharmacies that are majority-owned by a pharmacist, who may be affiliated with up to four pharmacies (in a city with more than 4,000 residents). At the same time, a general pharmacy may not have branch pharmacies in towns larger than 4,000 people.
There is also a ban on vertical integration, aimed at heading off overall control over the activities of a general pharmacy by a wholesaler, manufacturer or healthcare provider.
The changes will purportedly strengthen the pharmacist's role in the healthcare system, ensure the professional development of the pharmacy service and reduce the impact of commercial interests on it, the State Agency of Medicines (Raviamet) says.
Pharmacies remain open in the ongoing coronavirus pandemic, even in locations, such as shopping malls, which are largely otherwise closed for business. Over-the-counter medicines are taped off, however, and have to be verbally requested from the pharmacist. In addition, purchases of many over-the-counter drugs, such as ibuprofen or aspirin, are limited to two packs per purchase, to avoid hoarding or panic buying during the emergency situation.
Editor: Andrew Whyte