Galery

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Marina Nikolova

There are 12 000 pharmacies in Greece or three times more per capita than in other European countries. Even assuming that the country’s geography can easily explain this it is a bit strange that there are 1,250 pharmacies in the Thessaloniki area - as many as in the whole of Austria, according to data from the Greek Pharmaceutical Union. One provision in the new bill of the Ministry of Health allows twice as many pharmacies to be opened within a radius of 125, 6 meters around hospitals and clinics and this is what pharmacists themselves oppose. They argue in a document containing suggestions and comments on the bill sent to lawmakers in the Greek Parliament that under the current law a pharmacy could be opened 10 metres away from a working pharmacy near a hospital. So, they wonder why this provision is necessary to be amended and whether this will lead to opening of pharmacies with benefits. Another interesting point is that 35 out of 40 pharmacies in Ceres are located within a radius of 200 meters to the hospital, said the document again.

Another proposal of the Union of Pharmacists in Greece to the government is to adjust higher pharmaceutical education to other fields in order not to offer young students only opening of a pharmacy as the sole purpose of getting a diploma. They should be offered other opportunities for professional development that actually exist now. According to the pharmacists, there is a minimum number of pharmacists in the largest health insurance fund IKA and there are 83 vacant jobs in hospitals.

We are ready to help but we are not to be ruined – this is the main message from the interview with Thanasis Papatanasis who is secretary general of the Greek Pharmaceutical Union:

- One of the thorns for you, the pharmacists, in the bill is the cancellation of restrictions on ownership. What is your suggestion?

- Because the law is not clear we want the Minister to precisely and clearly formulate that the pharmacy is owned by an eligible independent pharmacist without allowing formation of chains or involvement of business interests of pharmaceutical or other companies. This means that only a pharmacist should work as chemist and should hold 51% in case of company or the entire pharmacy if it's private business. Currently, the law is unclear. We want the words of the Minister to be put in writing in the law.

- How many are the pharmacies in Greece currently?

- They are 12 000. This is three times more than in other European countries. Pharmacies in Greece are scattered and located so as to serve people everywhere - in very small mountain villages, on remote islands. I believe that the law applicable now has helped to avail pharmacies well located throughout the country.

- So, you think the previous restriction on one pharmacy per 1500 people is necessary to be kept rather than one pharmacy per 1000 people as currently provided in the bill.

- This change is not necessary now since the actual allocation of pharmacies in Greece is one per 850 people. So, there is no reason this regulation relating to population to be introduced. There is no need to change the old law which guarantees that no new pharmacies will be opened. And as the minister himself said, the increase in their number would increase pharmaceutical costs. On the other hand, this is not necessary in terms of their location throughout the country because the needy are served well.

- What do you think – will the funds pay their debts to pharmacies?

- The organization for treatment of employees insured in the public sector is the fund that owes us the most money - more than 450 million euros. We have already prepaid the amount of the value added tax which was around 75 million euros. We went so far as to take bank loans at high interest in these difficult times of economic crisis and we think that this can not continue any longer.

- Chemists in Piraeus said that patients having prescriptions issued by five health insurance funds owing them money will pay cash for the drugs...
 
- They do not accept in Piraeus prescriptions issued by the organization for treatment of employees insured in the public sector and by other insurance funds that do not pay their debts to pharmacists within the legal frameworks. And this is a matter of survival for Greek pharmacies.  

- Yes, but what will happen to the people insured by these health funds irregular in their payments. Won’t they get their meds?

- We are talking about medicines prescribed by several small health insurance funds which do not pay. We take the side of health insured and therefore the Greek society is behind us and supports us. We try to protect pharmacies because they are not commercial stores and medicines are not commercial goods. They are social good that should be available to the Greek citizens. We want to protect the interests of health insured but also the state's economy, which by increasing the number of pharmacies will also increase pharmaceutical costs. We try to protect the health insurance funds. Only we have made concrete proposals to the government - and the price decrease was proposed by us. This has significantly reduced our profits and turnover. We want to help but we do not want to be ruined. Because medicines are only 7% of the health care costs of the government. But we have not seen the Minister to slave away for the remaining 93% which he lacks.  

- What do completely free opening hours mean for pharmacies?
 
- We were told that we must work six days a week as many hours as we want – there are no restrictions. Given that each pharmacy is required to be on duty sometimes during the day when the rest are closed and sometimes to be on night duty.

- Have all health insurance funds started to issue electronic prescriptions? When will this happen?

- The electronic prescriptions were our idea. The current President of the Hellenic Pharmaceutical Union Ambadzoglou was deputy manager of IKA when he proposed this measure in order prescriptions to be controlled. We want transparency and control, because it is to our benefit but mostly to the benefit of our country and to the health insured Greeks. We support the attempts of Greece to reduce its deficit but this will not happen with the measures taken by the Ministry. First, the increase in the number of pharmacies, as I said, would increase pharmaceutical costs, so the problem would still be in pharmacies but the Minister would take the responsibility. Furthermore, the completely unlimited working hours will make problems for Greek pharmacists because as you know no one works 75 hours per week nowhere in the world. It is not only contrary to all labour laws but it is dangerous for patients. As for the electronic prescriptions, the health insurance fund of the free professionals has introduced this system completely. Their status at the other health insurance funds is beyond our competences – the Ministry should be aware of it.

- What are your suggestions to the Ministry of Health?
 
- We made suggestions for the proper pricing of medicines which was not properly made and cut prices by over 30%; for the electronic prescriptions. We made suggestions for the clusters – i.e. several pharmacists to be able to divide the same room, same door. Issues on which we agree in the bill were proposed by us. Currently, the ratio of 1/3 pharmacies/pharmaceutical companies to reductions we have agreed to make for health insurance companies is not met.

Just the opposite – the Minister proposes a larger percentage of reduction of 4,5% by us. Let’s make it clear that 22.8% of the final price of a medicine go to pharmacists, the producing company receives 63%, while the remaining percentage of the total price of the drug are to pay the VAT and the supplier. The profit proportion between the pharmacist and the manufacturer is 1 to 3 from the price of the medicine and we want it to be observed in the reduction of the price. And do not forget that nobody in the Ministry have received any euro from pharmaceutical companies and the rebate which was passed by the previous law. As result, this industry has over 200 million euros debts to the health care sector. Industrialists are obliged to grant a reduction of 4% and we would like reduction of 1.5% of the price to be applicable to us. The Minister proposes us to reduce our prices by 4.5% which is unjust and illegal. We have agreed to reduce the prices without complaining which means that each pharmacist looses between 15,000 and 20,000 euros on average from items already purchased.

Another very important point is the list of medicines without prescriptions. It will be discussed these days. This creates two types of patients and reduces the pharmacies’ sales. These are some cough and other minor illnesses medicines that would be sold with no prescription. This means that people would pay them out of their pockets.