Opposition MP Jevgeni Ossinovski (SDE) has called the coalition decision to reopen discussions on a bill amending the Medicinal Products Act political corruption, ERR's news in Estonian reports. Coalition representatives have said that an agreement has not been met on how to proceed, however.
As reported on ERR News, the coalition is looking again at the amends, it says, in order to find the best solution for availability and affordability of medicines. The sticking point in the proposed changes revolves around the aim to separate retail pharmacies from wholesale suppliers, by giving greater control to dispensing pharmacists in their sector and the healthcare system, rather than larger businesses.
Ossinovski, a former health minister, noted on his social media page that he had anticipated the development.
"When the current government became a reality in spring, I was convinced that a pharmacy reform would soon hit a sticking point," Ossinovski wrote, according to ERR's online Estonian news.
"[Businessman Margus] Linnamäe bought the Isamaa parliamentary group, EKRE is for sale, and the Centre Party is ready for anything to keep the coalition in [office]," he continued.
Margus Linnamäe owns Terve Pere Apteek OÜ, parent company of the Apotheka pharmacy chain.
"I was surprised to discover that [Centre Party social affairs minister] Tanel Kiik is ready to protect patients against pharmaceutical tricksters," he went on.
Tanel Kiik said in August and September, that one third of pharmacies already met the requirements the proposed amends were to introduce, adding that greater state control of such a large sector was needed.
At the time, Director General of the Agency of Medicines (Ravimiamet) echoed Kiik's comments that the move towards the removal of wholesalers' control was on course.
Kiik said Tuesday that his ministry still backed pharmacy reform.
"However it seems that my prediction is still coming true," Ossinovski added in his post.
"Tanel Kiik is more costly when in power, since as a close associate of the prime minister, it would not only be within his powers to veto Isamaa's political corruption, but also an obligation under his oath of office," Ossinovski continued.
Kiik, according to ERR's Estonian news, had backtracked from pushing ahead with pharmacy reform by April, though said his ministry was still behind the proposals.
"In order to leave no doubt as to why the government is pushing ahead with last-minute reform aimed at serving the interests of pharmaceuticals chains, Priit Sibul, who is also Isamaa Secretary-General, has asked for (and received) the money from Linnamäe. This is a matter of political corruption, not of social policy," Ossinovski added.
Most pharmacies not in line with proposed reforms are owned by larger chains
Pharmacy reform has so far stalled because larger chains have shown little interest or willingness to sell up to dispensing pharmacists. As a result 329 pharmacies which currently do not meet the amendment requirements are in danger of being closed, over 80 of which are located in rural areas or small towns, and the rest in towns with over 4,000 inhabitants.
The bulk of the pharmacies in question are operated by chains like Benu and Apotheka.
Earlier this month Tõnis Mölder (Centre) and Priit Sibulk (Isamaa) of the Riigikogu's social affairs committee said that the requirements on pharmacy ownership were not realistic within the planned time-frame (by Apr. 1). This also followed pressure from lobby groups, the Estonian Pharmacies Union (EAÜ) and Association of Pharmaceutical Wholesalers (ERHL), who said in September that a survey showing the majority of the Estonian public were in favor of the reforms had been conducted disingenuously. The EAÜ had also said large numbers of pharmacies would have to close as a result of the proposed reforms.
From the pharmaceutical companies themselves, Tamro, parent company of the Benu chain of pharmacies, said that the proposed reforms themselves should be ditched.
The Centre Party also received a donation reported at €100,000 in Q3 2019 from Ivar Vendelin, a business associate of Margus Linnamäe.
For his part, Tanel Kiik denied that the donations had anything to do with the social affairs committee's volte faace on the issue.
Priit Sibul's position
Priit Sibul told ERR on Tuesday that the coalition was prepared to reopen the bill aimed at pharmacy reform, though did not give any details on what form this might take.
Sibul also said that there was not consensus yet even within Isamaa itself, with some in the party or in the coalition thinking that some medicines could be sold in supermarkets, and others who were not in favor of major changes.
"It is our position that we do not have to wait till Apr. 1, because there is a large number of pharmacies that would close [as a result]. We do not have to wait for that moment," Sibul said, adding that he was not sure if agreement would be met next week.
Tanel Kiik latest statement
As noted Tanel Kiik still stuck behind the principle of reform along the lines of separating retail and wholesale in the sector.
In a written comment to ERR, Kiik said that: "A coalition task force met in parliament today and discussed issues related to pharmacy reform. It was agreed that all parties would submit their proposals for a possible amendment of the drug law, and discussions would continue in the coming weeks."
"The aim of pharmacy reform is to separate retail and wholesale of medicines to avoid conflicts of interest in the pharmaceutical market and to link pharmacies more closely with the rest of the health sector. The Ministry of Social Affairs supports the goal of pharmacy reform."
Estonian pharmacies enjoyed a turnover of €391 million in 2018, 73 percent from medicines. The bulk of sales were prescription medicines, to which the Health Insurance Fund (Haigekassa) contributed €146.5 million.
Editor: Andrew Whyte