Poland

Over the past several years we have observed rapid changes in the pharmaceutical sector. The way a community pharmacy is perceived by patients and our daily work have undergone transformations. Unfortunately, these changes have rarely been positive.

The most terrifying for pharmacists, and regrettably the fastest growing practice, are new pharmacies located within a short proximity to already existing ones. The number of community pharmacies in Poland amounts to 13516 (as of 1 November 2016), and year by year, month by month, we have observed a systematic growth in this number. In comparison with the same period last year, the number of community pharmacies has increased by 186. There is no document that would introduce geographical constraints on new pharmacies licences, taking into account both the number of patients per pharmacy and the distance from another community pharmacy. We should also pay attention to the increasing phenomenon of focusing retail turnover on one entity. Individual pharmacists are more and more worried about competition from networking “giants”. In addition, a person who is not a pharmacist can own a pharmacy, provided they have enough financial means.

In such a case, calling a pharmacy a “public health facility” is convention, since who is supposed to monitor this health care anyway – a random owner. A pharmacy manager who is an MPharm will never have a stronger position than a pharmacy owner, and for a person with no medical education, patient interest just does not have to be most important. Thus, we can encounter a situation where a pharmacy will be treated only in business terms, and its superior objective will be to earn the highest profits possible.

We have come to a point where there are more pharmacies in a given area than necessary to supply the patients. Then, a pharmacy must be competitive, and facilities that are not able to pay their way are liquidated. The entire medical assortment is disposed. From an economic point of view, this is a problem both for the owner of the liquidated pharmacy and the patients. The former will not get the costs of the purchased medicinal products back. In the event of a pharmacy liquidation, an enormous amount of medicines, often difficult to get access to in the market, are involved. The patient is the one who loses most when medicines that could help him/her are involved. Such a state of affairs should be stopped and we should prevent repeating such “mistakes” when setting up new pharmacies.

A similar situation exists in hospitals. We can observe the transformation of hospital pharmacies into hospital pharmacy departments, whose number considerably exceeds the number of hospital and company pharmacies (874 compared to 540 hospital pharmacies; as of 1 April 2016). Nevertheless, Polish Pharmaceutical Law does not define precise requirements hospital pharmacy departments should meet with respect to interior requirements or manager employment.

As educated people, pharmacists spend many years acquiring very unique knowledge about patient health care which is irreplaceable. We should have opportunities to use this in our daily work, without fighting with one another, because it influences first and foremost the patients. There are a lot of arguments for making specific changes in our daily functioning. A newly developed parliamentary bill includes proposals submitted by NRA [Supreme Pharmaceutical Council] that is representing us. I hope it will be accepted. All the more so as it is supported by the Ministry of Health, and our pharmacy community has not had the opportunity to implement such proposals, that we have been soliciting for a long time.

• Piotr Merks – EPHEU Observer member, Collegium Medicum, Drug Technology Department Bydgoszcz Poland, Mazovian Pharmacy Board, Poland
• Michal Byliniak – President Mazovian Pharmacy Board, Poland
• Urszula Religioni – Warsaw School of Economics, Poland
• Urszula Włodarczak – Collegium Medicum, Drug Technology Department Bydgoszcz Poland
• Damian Swieczkowski – Medical University of Gdansk
• Prof. Milosz Jaguszewski – Medical Unviersity of Gdansk