Ministry's inaction will lead to pharmacy crisis, reform impacts unknown

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Supply problems hitting more and more drugs
Supply problems hitting more and more drugs Source: Siim Lõvi /ERR

A thorough analysis of pharmacy reforms has not been carried out and the impacts over the next five years are not known, the Estonian Pharmacies' Association (EAÜ) said, which is why more than half are in danger of being closed in the spring which will lead to a crisis in the sector.

"There is not even a crisis plan to prevent a crisis concerning the availability of medicinal products. One's failure to act will be blamed on today's pharmacy owners. Years of inaction and indifference by the Ministry of Social Affairs have led to a situation where the whole sector is on the verge of a crisis and more than half of Estonian pharmacies are threatened with closure in the spring," Timo Danilov, member of the management board of the EAÜ said.

Danilov said an extremely strange situation has developed. "The Ministry of Social Affairs, the leader and the one responsible of the pharmacy reform, has not provided pharmacists with serious support in acquiring pharmacies, let alone provide crisis plans and impact analyses, which are elementary with such an important topic. At the same time, they have taken on the role of legislator and called for poor implementation of the reform and the ruling out of amendments. The rhetoric of the ministry representing the executive power ignores the rule of law and separation of powers, making patients the victim," he said.

As of April 1 next year, over 300 pharmacies across Estonia are in danger of closure, which means that the availability of medicinal products will deteriorate or even disappear in many parts of Estonia. "Access to medicines is not an issue to arrogantly and snidely debate in public and say that things will fall into place on their own. What has also not been analyzed is what will happen if a new pharmacist-owned drugstore goes bankrupt, which often happens when small businesses are started," Danilov said.

He said that the Ministry of Social Affairs has been promising to present the impact analysis, implementation mechanisms and risk plan of the pharmacy reform for five years, but so far they have not been able to or willing to develop them.

"At the last minute, immediately ahead of public broadcaster ERR's show 'Suud puhtaks' on Oct. 22, the Ministry of Social Affairs sent a strange document to the Estonian Pharmacies' Association, which one cannot categorize in any way. It is impossible to consider such a document as an analysis or action plan. Something has been done just for the sake of doing it and being able to check it off," Danilov said. 

For example, in the aforementioned document, the Ministry of Social Affairs claims that materials have been developed to assist pharmacists that offer information on what should be taken into consideration when establishing a pharmacy. But these guidelines are simply a formality and do not help or motivate anyone to become the owner of a pharmacy in real life, the association said.

On Oct. 22, the Ministry of Social Affairs sent a letter to the social affairs committee. "We also analyzed the need for creating additional credit measures for pharmacists seeking to acquire a pharmacy, but the mapping of the situation confirmed that there are various possibilities already in place for applying for financial means, which is why it is not necessary to establish additional measures. For example, measures offered by KredEx - starter loans as well as loan guarantees - can be used to support the financial capacity of pharmacists," the ministry wrote.

The EAÜ said, this is a sign of the fact that the ministry has not considered it necessary to develop any real support mechanism. "Practice has shown that pharmacists do not actually have the ability to acquire a pharmacy at a fair price. The state has not thought about additional financial guarantees in a situation in which a large number of entrepreneurs should start pharmacies at once," the association said.

The association added that the only worthwhile initiative was carried out by the State Agency of Medicines, which created a map application that shows how many pharmacies are in danger of being shut down by region. The application gives a clear overview of the actual crisis situation, the association said. 

EAÜ includes, among others, Terve Pere Apteek OÜ, Euroapteek OÜ, Pharma Group OÜ using the Heart Pharmacy brand and Benu Apteek Eesti OÜ.

Margus Linnamäe's Magnum AS is the owner of the Whole Family Apteek OÜ chain, which manages the Apotheka brand.

The Ministry of Social Affairs commented on the statement from the association and said that medicines will remain available throughout Estonia even after the end of the transition period for pharmacy reform. 

A statement from Marika Priske, secretary-general of the Ministry of Social Affairs, said: "The Estonian Pharmacy Association, representing wholesale pharmacies, misleads people and sows unjustified fears. Its sole purpose is to influence the Riigikogu to amend the law, which came into force almost five years ago, in the interests of wholesalers' business.

"Towards the end of the pharmacy reform, Timo Danilov, the Estonian Pharmacy Association representing the pharmacy chains owned by wholesalers and its director, Magnum Quality Director, has begun to scare the people of Estonia by interrupting the availability of medicines. Such misleading people is unacceptable and irresponsible.

"Instead of dealing with the activities that the Riigikogu gave during the remaining transition period, we have begun to scare our most vulnerable patients. The sole purpose of such action is to influence the Riigikogu to change the law in the interests of a narrow circle of tycoons." 

As of Oct. 1, there are over 200 pharmacies in Estonia, fully compliant with the requirements.


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Editor: Helen Wright

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