The Estonian Pharmacies Association (Eesti Apteekide Ühendus) and the Association of Pharmaceutical Wholesalers (ERHL) were referred in a joint statement to a ministry survey which said that 77 percent of Estonian residents expect pharmacies to operate independently from the business interests of wholesalers of medicinal products.

The government has also put in place a deadline of Apr. 1, by which time Estonian pharmacies should do just that, with majority shareholders in pharmacies being independent as mandatory. One third of pharmacies already meet those requirements already, according to social affairs minster Tanel Kiik (Centre).

Survey a distraction

"They [i.e. the ministry] are trying to distract people's attention from the fact that there aren't enough pharmacists in Estonia to fill the gap that is about to replace the current pharmacies," board member of the Estonian Pharmacies Association Timo Danilov said in the industry bodies' joint statement.

Danilov added that the details connected with the reforms and their financial implications have also not been sufficiently thought through.

"Some 75 to 78 percent of Estonia's pharmacies are about to cease operations as a result of the reform taking effect from April 1, 2020," Danilov said.

"The most trivial of the survey's statements was that that 96 percent of respondents find that pharmacists must be based in their activities on patient needs," Dainlov continued, noting what in his view was an example of the survey's push-poll nature.

"This obviously goes without saying and it is already currently guaranteed; it's not something that needs to be asked, using the taxpayer's money. They might as well have asked if there should be world peace," Danilov continued. 

Far-reaching impact on sector

Danilov also said the survey did not ask whether or not people would agree to the pharmacy reform without the effective assessment of its implementation and impact, given the large number of pharmacies that would need to close.

"In 2015, TNS Emor conducted a survey that indicated the Estonian public considered pharmacies to be the most valuable service sector," Danilov continued, adding that the Estonian populace is very satisfied with the availability and service level at pharmacies as it is.

Head of the ERHL Teet Torgo noted that pharmacy reform may result rising medicine costs, since it is the current link between pharmacies and wholesalers causes economies of scale which prevent keeping mark-up rates from rising above the minimum set by the state, a relationship which the reforms would destroy.

"The present high level of pharmacy services is corroborated by annual inspections by the Agency of Medicines (Ravimiamet), which have detected shortcomings in small pharmacies operating alone without any support structure," Torgo continued.

The two organizations' position is that the reforms entail major, unwise changes, possibly resulting in unforeseen risks to public health, the functioning of the pharmacy market, the availability of medicinal products, and to patients, pharmacists, pharmacies, local governments, the state and its, due to the unavoidable expenses and possible damages claims for damages relating the availability of pharmaceuticals, BNS reports.

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