Pharmacy administration bill will be built around the concept of liberating urban market beginning the coming June while the top successful city pharmacy owners would be expected to open shop in villages. This is the plan put down by social ministry as requested by Social Affairs Committee at Riigikogu.
The plan prescribes that initiatives to have rural pharmacies ought to be coming from local governments. The right to demand a pharmacy would be for such rural governments as have the closest one at over 30 kilometre distance for a minimum of 2,000 people.
The next step would be State Agency of Medicines picking one to establish it – from among pharmacy chains that have acquired at least 10 pharmacy licences in cities of 20,000 inhabitants and above i.e. Tallinn, Tartu, Narva, Pärnu or Kohtla-Järve and who have been the most profit-making. Obligation to keep a country pharmacy could be imposed for up to five years, and the chain should get the pharmacy going in 180 days.
Citing the early stage of it, social ministry yesterday refused to substantiate how the extra burden would ensure that countryside will keep its pharmacies. But they did assure us the impact of the change has been discussed, including with State Agency of Medicines. If ratified, the requirement will apply to all pharmacy market players starting this June.
«For the state, this is not the simplest solution, but I’d say it’s a wise solution,» explained Social Affairs Committee chairman Heljo Pikhof.
As underlined by Ms Pikhof, the version has not been decided yet. Three more variants are on the table, to be deliberated by the committee with interest groups on November 13th.
Possibly, operating subsidy could be paid to keep the rural pharmacies going (like some €20,000 a year), or some €30,000 granted to open a new one; or limits of ownership imposed on pharmacies so only dispensing chemists could keep them.
These versions were not used as basis for the bill for their obvious weakness as compared to the above obligation. Firstly, the state is unwilling to pay much as subsidies – yearly, that would yearly rob governmental coffers of €3–3.5m.
«State budget money is out of the question. Big money is moving on pharmacy market; the state needs his for other things such as handicapped children,» said Ms Pikhof.
Handing the pharmacy-keeping right to dispensing chemists would indeed maintain the rural pharmacies and reduce the lack of specialists, but a dispensing chemists’ chamber is only being created and will hardly be ready to bear the burden of administrating the market.
«Should they assume the responsibility, it would be a big step forward; but this can’t be done today and at once. It could be done within a decade, but we need the new arrangement by June,» explained Ms Pikhof. The debate looks to get heated, as none of the interest groups is totally satisfied.
«This is rather just cosmetics. The main problems are lack of professional staff and the overabundance of pharmacies in cities, leading to waste of resource,» said Estonian Association of Pharmacists board member Tanel Terase – one among the experts who say city pharmacy establishing limits must necessarily stay put even after the temporary limit ends in June. Otherwise – as the market gets liberalised and pharmacy boom hits the cities – workers are pulled out of current countryside pharmacies and these may hit economic hardship.
In its thorough analysis sent to the ministry and the committee, the association is concluding that the best option to keep pharmacy network balanced is to impose limits in cities and support such as operate in rural areas.
Sworn lawyer Ants Nõmper, with a history of representing small pharmacies, agrees while offering another solution. «High time for the state to start directing where pharmacies are established so the network becomes need-based,» he thinks. According to Mr Nõmper, politicians have thus far shied away from taking steps decisive enough, wherefore the best future option would be limiting the pharmacy-keeping right with dispensing chemists.
Social committee’s Heljo Pikhof says the bill can’t artificially cut numbers of city pharmacies as the state has no basis to remove licences already issued without a term. The solution will be further settled upon at social committee meetings today and next week.
The time is precious, President Toomas Hendrik Ilves also having warned this summer that by end of November the bill needs to be ready. Behind the demand, there lies a pragmatic calculation: the act needs to be passed by this Riigikogu, as the next membership will probably lack the time to delve deep into the topic.
As this membership winds up in February, the pharmacy-regulating law must be ratified at end of January or in week one of February.