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By Supreme Court decision, limits on establishing pharmacies are hereby unconstitutional. In other words, the debate raised by Chancellor of Justice regarding the eight-years-old clause in Medicinal Products Act, is finally over. Even so, the judgement by topmost court is far from the solution; rather, this provides basis for regulating the field. So: get to work, Riigikogu!
Basically, the decision demands that medicines retailing, in its entirety, be reviewed on state level. With greater depth and thought, perhaps, than before. As always, sale of medicines will be a regulated business with limitations on labour force and sales activities alike. To find a solution, the court granted time: the decision only entering into force in half a year’s time.
So: how, then, to regulate? In simple logic, public interests might be expressed by three aspects. Firstly, that medicines be available, all over Estonian, as fast and easy as possible – no matter how retailing is organised. Secondly, that consultation be as high level as possible – so people would take the right medicine in right doses at the right time, knowing all there may be known about side effects etc. Thirdly, that prices be as sensible as possible.
All these aspects are closely intertwined, requiring calculated compromises. Favouring one, the other two may get a backlash. Differing from some neighbouring states where pharmacies, owned by dispensing chemists, dictate the show, Estonian market is ruled by pharmacy chains linked to wholesalers – a fact no doubt impacting the entire retail situation.
In the context of the above case, a lot was spoken on rural pharmacies: the current limitations supposedly protecting their existence. True, should competition intensify in cities, as the limits come off, new staff will be needed – one way being to draw employees from the countryside.
Allowing E-pharmacies and pharmacy buses as business model is altogether prudent; even so, hoping this would substitute for a village pharmacy would be naive, putting it mildly. Why not, maybe, sell some simple over-the-counter medicine in stores and shops; nevertheless, to think this will wipe away the rural troubles may only be harboured by city slickers who, on their summertime-countryside vacations, have the occasional headache.
Cities may also encounter problems. Pressured by lack of qualified staff, there may arise the temptation to employ persons less fit for the task. Already now, State Agency of Medicines has reprimanded pharmacies for low level of consultation – in a fifth of pharmacies, this is deficient. Studies show that people expect and need advice on medicines. A pharmacy is part of the medical system even if not so specified by letter of the law.