Vending machines, mobile pharmacies and affiliates instead of state-owned pharmacies

In late July, a bill was introduced in Parliament that briefly proposes:

The state to fund the opening of pharmacies, including 24-hour pharmacies, or the sale of medicines through vending machines in localities where there is a shortage of open pharmacies;

Proposes an 8% reduction in the profit tax for those who open a pharmacy in a locality where there has been none;

In communities lacking a 24-hour pharmacy, it should be possible to place a vending machine to sell medicines.

There are unfortunately villages and even entire municipalities that lack a working pharmacy, and even fewer towns have a 24-hour pharmacy. So far, so good. As the proponents of the draft point out, the private sector does not have an incentive to open pharmacies in 22 municipalities – the population is declining and there are no pharmacists willing to open business in them.

However, good intentions do not always lead to good results, especially when it is proposed that the state becomes the entrepreneur. The problems of remote and small municipalities are not limited to the lack of a pharmacy. To these we can add poor internet, problems with water and electricity, lack of kindergarten and cinema, etc., which does not at all mean that the state should provide these services, nor that it could do so in a satisfactory manner, even if it wanted to.

The proposal for a reduced profit tax will also not solve anything, because even currently there is a mechanism to support pharmacies that carry out activities under contract with the NHIF/RHC in remote, inaccessible areas or are the only contractor for the relevant activity in a municipality. Their number 173 as of July 2024.

There are at least several solutions to the problem of lack of access to medicines, which are well known to all concerned:

Placing vending machines for medicines outside the pharmacy premises – predictably, this idea has faced huge resistance from the pharmaceutical profession for years. At the moment, these can only be available if they are located within the pharmacy itself – which is, let’s face it, irrelevant to the problem at hand. The development of the telemedicine process, the development and upgrading of the national health information system, and electronic prescriptions are all reasons to finally ignore the resistance of pharmacists and expand economic freedom.

Mobile pharmacies – these exist informally in some municipalities, organized on their own initiative, which usually have a pharmacist and/or a nurse. It is time to legislate for this possibility so that anyone who wants to can provide this service without fear of sanctions.

Branches of existing pharmacies – with shorter opening hours, run by an assistant pharmacist, they can solve problems in a number of localities. Currently only Master Pharmacists can run a pharmacy, which seems as an unjustified restriction. Before this option was removed years ago, it was in fact assistant pharmacists who ran pharmacies in remote or sparsely populated areas where they often lived.

Home delivery of medicines from nearby pharmacies – this option is a mobile pharmacy option, but it is important that this should be possible for prescription medicines as well. Technological solutions to ensure compliance with all regulations have long been available.

Removal of the restriction that a person can open no more than 4 pharmacies. It is easily circumvented at the moment, is devoid of any logic and should be abolished.

As we live in the 21st century it is imperative to think logically, open-mindedly and boldly when solving problems which expand freedom of choice for the citizens.