Thursday 18 June 2009

Italian or Norweigian pharmacy model best for the citizens?

Italian MEP Stefano Zappalà claims, with referral to the ECJ decision, that "The Italian pharmacy model has also won in Europe". Not sure what he means with "also". Clear is that he is happy that ECJ "has put a halt to the push for the liberalisation of pharmacies by the European Commission in recent years." He continues: "The Italian pharmacy system, which is also the continental system, has been designed to protect citizens and to ensure their health is not endangered. " Now one of the issues with the Italian system is that only pharmacists are allowed to own pharmacies.

As reported earlier on this blog the European Commission have started infringement processes against member states with systems restricting ownerships in various ways. The lobby against liberalization have been fierce and Zappala is only one example of those fighting hard to avoid modernization of the sector. Whatever their arguments we know it can be done differently.

Kai Finsnes from the Norwegian Pharmacy Association recently gave a presentation in Athens of how the pharmaceutical distribution system can be improved for the citizens. He described the results of the Norwegian pharmacy deregulation in 2001. Before 2001 the government decided when and where new pharmacies were to be established. Only pharmacists were allowed to own pharmacies and they could not have more than one. Pretty much the system Zappala defends. Between 1991 and 2000 there were 3-11 new pharmacies established each year. With the introduction of free establishment (no need to be a master of pharmacy to own a pharmacy and legal persons may own pharmacies in combination with no limitation of the number of pharmacies that can be owned) in 2001 Norway have had 15-61 new pharmacies opened each year. So there are fewer inhabitants per pharmacy and an increased consumer focus. Pharmacies are thus easier accessible for every Norwegian.

Maybe even more important to explain to the defenders of the old time systems is that the competence in pharmacies have actually increased despite all the warnings about what happens when ownership etc are deregulated! Take a look at the statistics below.

So if quality is better and access is better, what do the citizens wants? The Swedish Co-operative Union (KF) (uniting the 48 regional consumer co-operative societies in Sweden, with over 3 million individual members) in a survey of their clients/members found that 90% states that they want to have pharmacy services in their organizations stores.

So whose interest was Zappala defending in his election campaign? If it is the citizens, I would say that he is very off the target.

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