Pharmacies: Reform may result in medicinal product access crisis

A new Benu pharmacy being set up at North Estonia Medical Centre (PERH).
A new Benu pharmacy being set up at North Estonia Medical Centre (PERH). Source: BENU

The Estonian Pharmacies' Association (EAÜ) sent a memo to the Social Affairs Committee of the Riigikogu on Friday seeking to draw attention to a possible upcoming crisis in access to medicines in connection with the pharmacy reform set to take full effect on April 1, 2020.

EAÜ board member Timo Danilov said that the risk is looming that some 300 pharmacies across the country will close next April.

"Facing closure are pharmacies that are not compliant with ownership restrictions — in other words, their shareholders are wholesalers of medicinal products, and the majority holding in these pharmacies is not owned by pharmacists," Danilov said in a press release.

"It's clear at this point that bringing these pharmacies in line with ownership restrictions is unrealistic, as there aren't enough pharmacists with sufficient financial capacity to purchase these pharmacies at a fair price," he continued. "Patients, pharmacists and pharmacies have been left to their own devices on the eve of the reform, and uncertainty with regard to the future is severe."

The ownership requirement affects an estimated 75-85 percent of the pharmacy market, the total fair price of which is a combined at least €200-250 million. If these pharmacies are expropriated or closed, pursuant to the Constitution, the fair value must b compensated to the business-owner by the state, i.e. taxpayers.

"It also raises questions about the reliability of the investment environment in Estonia, as a large share of these pharmacies are owned by German, Swedish and Lithuanian entrepreneurs," Danilov said.

The EAÜ said that residents' satisfaction with pharmacy services is currently very high, which is why it remains unclear what problems the mass expropriations are meant to solve.

The association added that it is also regrettable that the Ministry of Social Affairs decided in 2018 not to conduct any impact analyses into the pharmacy reform even though it was tasked by legislators with doing so. It also argued that this is the main reason why the unprecedented mass closure of pharmacies is now imminent.

'Closures could paralyze healthcare system'

To prevent the looming crisis in access to medicinal products, the EAÜ is asking for the Social Affairs Committee of the Riigikogu to immediately develop measures for avoiding the closure of pharmacies.

"The Estonian state cannot allow for a crisis to erupt both in the family doctor system and in access to medicines," the association said. "This would paralyze the entire healthcare system."

The EAÜ is a nonprofit body representing 293 pharmacies across Estonia.


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Editor: Aili Vahtla

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