© Lily Touszek
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The number of pharmacies in Bulgaria is almost twice as much as compared to the European average. This was announced at a press conference in the press club of the Bulgarian Telegraph Agency by the Bulgarian Pharmaceutical Union on the occasion of the World Pharmacist’s Day.
On September 25, 1912, the International Federation of Pharmacists (FIP) was established, which currently has 156 national pharmaceutical organizations as members, including the Bulgarian Pharmaceutical Union, many academic institutions and individual members.
The large number of pharmacies in Bulgaria means that they are not provided with a workforce sufficient for their proper functioning, said the chairman of the union, Dimitar Marinov. On average, three pharmacists in Europe work in one pharmacy, while in the country they are 2.1.
There are areas where there are no pharmacists in pharmacies contrary to legal requirements. 58% of EU residents reach a pharmacy within five minutes, while in Bulgaria this percentage is 78, informed Marinov. 98.6 of the inhabitants of Bulgaria reach a pharmacy within 30 minutes. “So in terms of insurance coverage with pharmacies, we are far above the average European data,” he added.
Last year, the total number of pharmacies in the country decreased, and according to the data of the Executive Agency for Medicines (EMA), they were 3,296, with approximately one third of them concentrated in the three largest cities – in Sofia there are a total of 740, in Plovdiv – 212, and in Varna – 171. The number of municipalities without a single pharmacy is 20, and those with only one are 40. Compared to the register of pharmacies from 2020, there are 500 fewer pharmacies in 2021, as most of the contraction is due to large cities.
Pharmacies become call centers looking for drugs
Dimitar Marinov said that with the advancement of digitalization, much of the paperwork has practically disappeared or been greatly reduced, mainly due to the mandatory electronic prescriptions under the National Health Fund. Due to many shortages, refusals and shortages of medicines, pharmacies have turned into call centers that search for medicines for their patients all day long, said Marinov. According to him, there is no register of recipes in Bulgaria, often they do not meet the requirements and all the details of Regulation 4, which specifies how a recipe should look.
Among the problems outlined by the Bulgarian Pharmaceutical Union are the provision of medicines, with a large part of the shortage problem being in the production and logistics part. There is a lack of timely and objective information on the consumption of medicinal products. There is an uncontrolled parallel export of drugs, regardless of whether it is legal or not, commented the pharmaceutical union. According to them, the possibility of generic replacement of drugs should be introduced, because Bulgaria is the only country in the EU that does not have the right to do so. It is also necessary to revive the production activity in pharmacies.
Another problem noted by the union is the so-called vertical integration in the drug supply chain – the same owners of pharmacy chains, warehouses and even manufacturers. It is possible that these vertically connected structures work for mutual benefit, so that they get a monopoly position, said Dimitar Marinov. According to him, such dependencies also lead to the possibility of limiting patients’ access to certain medicinal products, which are provided only to the pharmacies connected to the warehouses. In this way, patients are directed to these pharmacies as a priority, and other retailers and their patients are deprived of access to “deficient” medicinal products, he pointed out.
Another problem that pharmacists focused on is the inability of pharmacies to find medicinal products in their suppliers. The BFS proposes to further develop the System for Electronic Tracking and Analysis of the Availability of Medicinal Products (SESPA) so that every pharmacy has equal access to medicinal products and can serve its patients.
According to the pharmacists, any attempts to “solve” the problem of access to medicines and pharmaceutical care in small settlements where there is no pharmacy, through the so-called mobile pharmacies, vending machines, online sales or dispensing by unqualified staff is simply ignoring the problem. All such ideas, which periodically creep into the public space, especially before local elections, are particularly dangerous, especially in conditions of scarcity and significant vertical integration, according to the industry association.