There are more and more patients in Poland per one pharmacy. There is also a lack of drugs

Only last year there were over 820 pharmacies in Poland. The general development of the e-commerce market in the pharmaceutical industry is also severely flawed, because many pharmacies do not sell by mail order. In addition, there is also the problem of night shifts and the lack of drugs, which appears more and more often.

There are fewer and fewer pharmacies in the Polish landscape

From the report of the Central Statistical Office “Pharmacies and pharmacy outlets in 2020” shows that at the end of 2020, 12,1 thous. generally accessible pharmacies (a decrease by 1,9% compared to the previous year), 24 company pharmacies (as in 2019) and 1,2 thous. pharmacy points (3,2% less than in the previous year). These data indicate a decrease of 5,1%. on an annual basis. In a report published in June, Grant Thornton, based on data from the National Register of Permits for Running Pharmacies and Pharmacy Points, calculates that 2020 was another year of decline in the number of pharmacies. 828 entities disappeared from the market, from 14181 at the end of 2019.

– In 2020, we saw a decline in the number of inactive pharmacies, i.e. pharmacies that stopped operating while still having a permit. At the end of January 2021, there were 50 such entities, while a year earlier as many as 115. The number of pharmacies that reported the suspension of operations increased by 23 – at the end of January 2021 there were 276. In addition, eight pharmacies are awaiting a permit, and one was immobilized by the decision of the Provincial Inspectorate Pharmaceutical. In total, the total number of inactive pharmacies decreased by 42 entities, the company wrote in its report.

Moreover, in its study, the Central Statistical Office indicates that last year only 2,8 percent performed regular night duty. generally accessible pharmacies, and 19,3 percent. It had periodic shifts. Mail-order sales of medicinal products via the website were carried out by 223 pharmacies and 6 pharmacy outlets nationwide.

In Poland, there were an average of 1 people per 2020 generally accessible pharmacy and pharmacy point in 2 (897 more than in the previous year). As in the previous year, the largest number of people per one generally accessible pharmacy and pharmacy point was recorded in the Pomorskie Voivodeship (49 3), and the lowest – in Wielkopolskie (329 2).

The guilty pandemic? Not completely

Grant Thornton indicates that in 2020 the total sales in pharmacies amounted to PLN 37,7 billion and it did not increase significantly compared to last year. It increased by exactly 1,4 percent. (PLN 530 million). The highest sales were recorded in March and October, i.e. during the first and second waves of the pandemic. This was due to the “crowd effect” and the fact that society was trying to protect itself from the impending lockdown.

The authors of the report indicate that the 2017 amendment to the Pharmaceutical Law introduced new, more difficult to meet requirements related to opening new pharmacies and taking over existing ones.

In order to open a pharmacy, a number of conditions must be met, including the census of education, and its location cannot be within 500 meters from pharmacies already operating and in places where one pharmacy falls to more than 3 inhabitants of the commune (except where a new pharmacy is being built at a distance of more than a kilometer from the nearest existing pharmacy). Additional conditions must also be met in the case of the acquisition of an entity (including those related to the accumulation of ownership of pharmacies), which may not exceed 1%. pharmacies in the voivodeship, the report reads.

Franchise on censored

The spokesperson for Small and Medium Enterprises in his report presented at the Economic Forum in Karpacz indicated that pharmacies are victims of numerous inspections by the Provincial Pharmaceutical Inspections. In total, since 2017, voivodship branches issued a decision on the basis of various provisions on the withdrawal of a permit to operate a generally accessible pharmacy in 73 cases, and the decision to refuse to change an authorization had to be faced by 150 pharmacists.

A spokesman for SMEs also pointed out that the problem is blocking the growth of franchise on the pharmacy market. The main concern of regulators is that the franchisor takes control of the franchisee – and this already leads to excessive concentration on the market – then a capital group is formed. The Defender indicated that it is necessary to change the practice of questioning the independence of the entrepreneur only due to the fact of concluding a franchise agreement and additional agreements (e.g. loans, leases and maintenance services), if these agreements contain standard provisions for services of a given type and are contained in market conditions.

The Warsaw Enterprise Institute writes in the report “Polish pharmacy market. Key Facts and Figures ”published in November 2020 that the number of facilities is shrinking. WEI writes that taking into account the generally accessible pharmacies themselves (excluding pharmacy outlets), their number is also decreasing. From June 2017 to September 2020, 1 pharmacies in Poland decreased, and their number returned to the level of 253. Interestingly, chain pharmacies have lower prices, better availability of drugs, a wider range of products, etc. So they are more often chosen by patients. In July 2012, the statistical chain pharmacy was visited by over 2020 thousand. patients, compared to 4,2 thous. at an individual pharmacy. The turnover of the statistical chain pharmacy in July 2,5 amounted to 2020 thousand. PLN, against 266,4 thous. at an individual pharmacy.

GIF and restructuring of provincial inspections

On December 20, the Sejm hosted a meeting of the Parliamentary Team for the Protection of Consumer and Entrepreneurs’ Rights and the Parliamentary Team for Drug Policy, where matters related to the “verticalisation” of the Pharmaceutical Inspection were discussed. Last month, the minister of health appointed a special team to deal with issues related to the reorganization of the PIF. When it comes to problems with the functioning of PIF, entrepreneurs reported problems related to different interpretations of the law through voivodship inspectorates. As PulsMedycyny writes, at a session of the parliamentary team, Marcin Kisiel, the president of the Association of Franchise Pharmacies, pointed out that entrepreneurs want trust in pharmaceutical inspection authorities.

– Currently, we do not know how the law is interpreted. On the one hand, standing upright may seem like the desired direction, on the other hand, we have concerns about this change. All because the pharmaceutical inspection itself has changed the line of jurisprudence in the last two or three years and began to adjudicate to the disadvantage of pharmacy entrepreneurs – he said.

Paweł Chrupek, director of the Office of the Ombudsman for Small and Medium Enterprises, spoke in a similar vein, referring to the report published in September by the RMiŚP, which indicated numerous discrepancies.

– Today, our cooperation with the new minister GIF shows a significant change in the way the inspection is carried out. In this situation, this postulate of standing up seems to be a step in the right direction – he said.

PulsMedycyny writes that the GIF itself complied with the submitted comments and considered them justified. As a solution to this problem, he recommended changes in the inspection structure known as the verticalisation of the Pharmaceutical Inspection.

– In our opinion, this is a historic step towards integrating pharmaceutical inspection. It is a “separation” of provincial inspectorates from provincial administration – said Edyta Janczewska-Zreda, chief communication specialist at GIF.

In her opinion, making PIF a single authority is to make its decisions centrally located, primarily in order to optimize the inspection activities, increase its efficiency, standardize procedures and standardize the application of the law, writes PulsMedycy -ny.

Wholesale market and pharmacies

The wholesale market in Poland also has its own specific shape. PEX PharmaSequence in the report “The role of pharmaceutical wholesale distribution in ensuring drug safety in Poland” writes that there is a significant degree of concentration in the pharmaceutical wholesale market – the 10 largest entities account for nearly 90 percent. turnover of the entire pharmaceutical distribution market.

Sebastian Stodolak, the vice-president of WEI, writes in his comment that the situation on the wholesale market is extremely important for the stability of the retail drug market. The Act on the Reimbursement of Medicinal Products, Medical Devices and Products for Special Nutritional Purposes of January 1, 2012 also imposed on pharmaceutical wholesalers, among others rigid wholesale margins of 5%

– It reduced the income of wholesalers and it intensified the trend of market consolidation. Currently, with a highly dispersed pharmacy market (only 3% of pharmacies belong to the 8 largest chains), a highly capital-concentrated market of wholesale drug distribution has developed in Poland (the 3 largest wholesalers control 80-88% of the market). Such a great structural disproportion of the drug distribution market segments affects the relationship between the entities on the wholesale and retail market, favoring large, full-range drug wholesalers over a poorly integrated pharmacy market, he says.

Sebastian Stodolak emphasizes that the assessment of the state of market competition on the wholesale drug market rests with the Office of Competition and Consumer Protection.

– However, according to the fundamental principles of economics, the greater the competition, the better. In Poland, we face the problem of the lack of drugs in pharmaceutical wholesalers, so the greater the diversification of drug supplies, the better for pharmacies and the patient. Therefore, we should review the barriers that wholesalers face in their activities, such as the aforementioned rigid margins, and remove them, he says.

The Law for Development Forum in the study “Who stole pharmacies from Poles?” writes that “the strategy of building partner networks, based on financial incentives for pharmacists to sell products that bring the highest margin for the wholesaler, results in a dynamic increase in the financial results of the largest entities on the wholesale market. In the case of the company that conducts the most dynamic sales of its own products in the partner pharmacies of Neuca, it increased between the first three quarters of 2019 and 2020 by 10%, and by 8%. year on year between 2018 and 2019 ”.

Neuca writes in the last financial report for 2020 that it has strengthened its leadership position, reaching 32,1 percent in the fourth quarter. share in the pharmacy wholesale market, i.e. 2,2 percent, more than last year. In the report for the third quarter of 2021, Neuca writes that nearly 3300 pharmacies participated in the Partner +, Partner and IPRA partner programs at the end of the third quarter, i.e. nearly 140 more than at the end of the first half of 2021.

The Republican Foundation also writes about the concentration on the producer market.

– The concentration on the production market, depending on the product group, reaches 25 percent. Such a discrepancy causes disproportions in commercial contacts and prevents pharmacies from having real pressure to reduce prices by suppliers who have benefited from the fragmentation of the market for years. The largest wholesalers and manufacturers dictate commercial terms thanks to affiliate and marketing programs: they reward pharmacists for selling a specific assortment in a certain amount and make the availability of drugs and their prices dependent on the sales volume – writes the Foundation

Medicines are also lacking

In October, the “WherePoLek” portal prepared a list in which it collected information about the missing drugs in the country. The report takes into account only those preparations with a decrease in the availability of the product in pharmacies by at least 50%.

In October, there were, among others, such drugs as Anticol – containing disulfiram, which is used during the treatment of alcohol dependence, Canespor Onychoset – it is a preparation containing bifonazole and urea, has an antifungal effect, Clatra fluid – used for symptoms of hay fever and many others.

Dr. Łukasz Durajski, a member of the American Academy of Paediatrics, in an interview with the WP abcZdrowie portal, said that the shortages in pharmacies result from the fact that nowadays a larger group of people is ill than a year ago, and the shortages in wholesalers are the result of, among others, incorrectly assessing the need for drugs this season.

There weren’t that many infections last year and drug companies wasted a lot of money because these drugs weren’t that needed and unfortunately had to be thrown away. Now we have a completely opposite situation. Producers underestimated the demand and there is a shortage of drugs, said Dr. Durajski.

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