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Pharmacies in supermarkets

In Spain, only a licensed pharmacy can be owner and holder of a pharmacy. And you can not open it anywhere. The pharmacy-only establishments that sell drugs-are established by grant and planning according to criteria determined by geographic and demographic autonomous communities, which serve to ensure that all citizens have to hand

Thus, to gain a pharmacy, the pharmacist has to compete for a license, buying a someone who wants to transfer his or inherit. A very sheltered model where sparks fly whenever opening discussion. Now, the industry is back on the warpath after learning that the Ministry of Economy to boost competitiveness, liberalize the system has seen for anyone to open a pharmacy. But the idea has not pleased the Ministry of Health and some autonomy, they argue that, with the current model, pharmacies are more than a health worker gives a wide and good coverage to citizens.

The department proposed Luis de Guindos, Which was reflected in one of the papers with his technicians study the bill professional services (broad), mean entry into the business of large chains, with the only exception that regardless of who was the owner and holder of the pharmacy, the pharmacist would have to direct it. The Spanish model would thus be more like others, like Britain, where stores like Boots have a large market-or Dutch-where most of the pharmacies are in the hands of large groups. It would also open the door to premiere stands supermarkets to sell drugs.

Ultimately, disseminate and introduce new sales agents in the business, rather than establishing pass from father to son. A very common reality harshly criticizes the Open Platform for Free Pharmacy (Plafarma), asking anyone to open a pharmacy where you want, regardless of quotas for population established by the regions. Its president, Mercedes Acosta criticizedthe obstacles to face for pharmacists to achieve an award in 1941 from the system was created quizzes. Acosta believes that the rules hinder the new openings, and ensures that the current system perpetuates patronage. "With the liberalization of the pharmaceutical industry would be eliminated medieval privileges of those who come to enjoy the current owners of pharmacies, which can only be accessed by inheritance or transfer payment millionaires," he says. For members of this association, a good model to start is the Navarre. That is the only region that has claimed territorial and demographic quotas and allow pharmacists to open an establishment where they want. "Although it is best that liberalization is complete. Generate jobs, "says Acosta.

But while it is true that with the deregulation that glimpses of the proposedEconomyanyone could open a pharmacy, need capital to invest, something that is difficult now. Hence, experts point to large companies as the main beneficiaries of the measure. But while the health sector comes on and defends the current model, supermarkets and distribution companies, which at various times have shown interest in this field, open to remain cautious and prefer to remain silent until the liberalization is proposed firm.

It is not the first time that the debate is on the table and there is fear of a repeat of what happened in 2000, when the industry was prepared to sell in stores nonprescription drugs, a move that will certainly never approved. Some large establishments remained without boyfriend compounds.

The department Luis de Guindos, asked about the issue, also rejectsanalyze the model and possible changes. "There is nothing closed", they insist. They maintain that liberalization is not the official position of the Economy and the system is still being studied.Pilar Farjas, Secretary general of health, not to compare the current model with which hypothetically would be born with liberalization, but never tires of praising the model is known as Mediterranean-laying also govern Italy, Portugal and Greece-in that the pharmacist is a more public health agent. "It has a key role in the continuity of treatment, care and access to drugs. It also collaborates with the authoritiesthrough information programs, vaccination or prevention, "he says. "It's a very valid formula that works well and allows 99% of the population have a pharmacy close to home," he says.

With the current rules, in Spain there is a pharmacy for every 2,200 inhabitants. In the Netherlands, where large corporations have strong representation, pharmacies are located in the center of cities and there is one for every 10,000 inhabitants. This map, which places a pharmacy on almost every corner, would be the first to fade, as pharmaceutical companies and professional associations. Fernando Redondo, president of theBusiness Federationl Spanish Pharmacists(Fefe) believes that small establishments and many of those in the neighborhood, would cease to exist. "Opening the system to large corporations would push the disappearance of three of four pharmacies within five years, and that not only means the loss of many jobs. It is also an injury to the citizens who have fewer services, "he says.

Jesus Gomez, president of theSpanish Society of Community Pharmacy (Sefac) believes that the new system would involve a change in the current territorial regulation. The expert believes that with liberalization, the concession system that guarantees coverage for citizens would die. "The big commercial groups would better placed with pharmacies and smaller or established in rural end up closing," he predicts.

These pharmacies are people sometimes remember the president ofGeneral Council of Pharmacists, Carmen Pena, the only health workers such smallsized populations or marginalized urban areas, so play a key role. However, often unprofitable businesses that now, in the case of rural subsidized to stay. "What would happen to them? And to those who are in places where it is not profitable a pharmacy? Now their presence is guaranteed. With the liberalization not, "says Gomez.

Besides influencing the social point of view, those responsible for the Pharmacy Board cast doubt on the arguments outlined Economics in its working document, which states that the current regulation is "excessive and outdated" and argues that reforming it would improve the economy and generate more competition. "A change in ownership will not produce pharmaceutical-ownership savings in public spending on drugs. This only depends on the number of prescriptions written by doctors and drug prices, a price that is regulated by Health ", they say. The public health system finances 80% of drugs dispensed in the pharmacies; those for that price fixing.

ToRicard Meneu, Physician and economist links to the Institute of Health Services Research, the argument is spurious price regulation. "Indicates the maximum price and discount allowed some leeway," he says. Discounts, adds, which occur between laboratories and pharmaceutical distributors, however, not reach the final destination, the buyer. "And as for the other products ... if someone is willing to pay for child nutrition cosmetic or more money for similar products just because they are sold in health trade, not for me to discuss what should be wasting their money "continues.

Indeed, the industry is going through a very difficult. The defaults drown Administrationsmany pharmacies, Accumulating unpaid bills for millions of euros. The Castilla-La Mancha and Valenciahave come to strike for it, The Canary Islands have referred go to court to claim what that communityowed.

But, if the business of a pharmacy is not what it was and the profit margin for drug prices is not as sweet, why the big chains would be interested in sticking your head in this area? Sefac President points out some reasons: "The chains would assert their economic power and end up staying with the most profitable pharmacies. Also, could be introduced as an agent on every link in the chain and monopolize a part of the market. They could, for example, produce their own generic drugs with your brand, distribution and, of course, in the case of the counter, specify them and dispensed. So, surely their products take precedence over others. "

The reform would exploit other two fields. One is that of medical devices, an area with a large-and growing market-in which there is still much room for maneuver. Another is that of advertising. Now, the law only allows OTC drugs are advertised as cold remedies, some painkillers, laxatives ... Apharmacy chain or supermarket could start to advertise their discount offers. Or advertise other services such as measuring sugar free, advise on a diet ...

It would also mean a major change to find a stand with drugs-yes, a pharmacist-led next to the butcher or grocery section of a large supermarket. Model is, however, common in the United States, where pharmacies are great stores that you can buy from a pregnancy test or a pack of antihistamines to a frozen pizza. A system that has some risk, according to the head of the Sefac. "Selling drugs in supermarkets contributes to trivialize the drug. With these measures are not blocks the problem of overuse, "he says.

The doctor and economist Meneu, however, that opening looks positive in the case of non-prescription drugs, "Now that so many drugs have been underfunded for smaller entities should treat citizens as adults comparable to those of many countries in our entornoy allow its sale, and there yes, price competition-in other stores. "

But while the debate on industry models and formulas, which worries the patient is that change with a loss of quality of care. "The liberalization seems a new bet in favor of markets, clearing a model that has been operating in Spain for many years with positive outcomes for patients," says the president of theGeneral Alliance of Patients,Alejandro Toledo, concerned about openness favors economic interests compared to health.

Since the sector is also critical that the arguments that underpin the plan are basically economic. But the suggestion is that liberalizing pharmacies comes from Brussels as one of the ways to reduce macroeconomic imbalances. And not the first time these winds come. In 2006 the EU and Spain advised to review their model, although after another contentious debate-and a tug of war between the Ministries of Economy and Health-liberalization not approved.

The issue has many sides and is controversial not only in Spain. In Italy and Germany have reached the Court of Strasbourg has also been some judgment on Spain. Three years ago, before several end posed resources required to be licensed to own a pharmacy, European judges ruled that it is the prerogative of each state to decide the best regulation to ensure the safe and quality supply of medicines to the population.

A criterion also outlinesnumber twoof Health, which emphasizes that the pharmacy is not a store to use. "It is a cog in the health system. In addition, the requirement of ownership of pharmacy ownership allows the criterion of professionalism prevail over other interests, "said Farjas. The president of Plafarma also defines pharmacy as a health worker vital, but remember that, in addition, the pharmacies are inherited. One of the few privileges that survive free market laws.

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