2024-09-19 23:46:45
The branch threatens with protests and that it will appeal to the EU. And now if one person carries a suitcase with medicines for everyone in the village, is it good, politicians ask
Can drug vending machines open the way to drug abuse, instead of being a solution to the problem of the lack of pharmacies in a number of settlements, especially the hard-to-reach ones? The topic has seriously riled pharmacists and MPs less than a week after the parliament passed the first reading of amendments to the medicine law. They expand the circle of 24-hour pharmacies, but also make it possible to place medicine vending machines in places.
According to the texts adopted on September 12, the state will finance the opening of pharmacies, including 24-hour pharmacies, or the sale of medicinal products through vending machines in the regions, municipalities and settlements for which a shortage of pharmacies, including 24-hour pharmacies, has been identified in the National Pharmacy Map. Funding will be carried out according to the criteria and order determined by an ordinance issued by the Minister of Health after coordination with the Minister of Finance.
The pharmacists, however, responded with a threat to protest and a warning that they will refer the European structures to how the free sale of medicines is legalized in our country.
The bill was submitted by “Vazrazhdane” and passed with 119 votes “for”, 12 “against” from DPS and 22 abstentions, mainly from PP-DB. Former Health Minister from GERB Kostadin Angelov promised to make changes before the second reading.
The reason for the deputies to accept it was that
there are no 24-hour pharmacies in 13 regional centers,
and the situation in municipalities is even worse. In remote areas, people travel tens of kilometers to buy medicine.
The change will not improve their access to medication, but will worsen it, explained the pharmacy sector. Because the machine allows you to buy a medicinal product without consulting a specialist.
Medicines are not candy or wafers to fall freely from uncontrolled vending machines, pharmacists fume. They are convinced that this will stimulate self-healing.
“Who will be responsible for the drugs dispensed from the machine, because by law it is the pharmacist? Who will load these vending machines? What will be put in them?” asked Nikolay Kostov from the Association of Pharmacy Owners. Point out that
in Europe, there are such machines only on the territory of pharmacies,
but under regulation what can be loaded into them – only medicines without a doctor’s prescription and in small packages.
And we currently have medicine machines with the express requirement that they be on the territory of a pharmacy – so there is control, an opportunity for the patient to receive a consultation, and the pharmacy itself ensures the filling of the machine. Their presence on the premises of the pharmacy makes the idea pointless – the patient would prefer to get them from the live person behind the counter together with a consultation, deputies explained during the first reading of the law. In addition, there is no access to the machine during non-working hours. In certain settlements, precisely to circumvent this restriction, the machines were next to or built into the wall of the pharmacy, so that they could be used when it was closed.
Importers from “Vazrazhdane” reassure that vending
the machines will be registered and under the control of the Medicines Agency
They will not offer prescription-only drugs, and they will not be placed in major cities. I.e. the business of already existing pharmacies will not be affected, reassured the branch the deputy head of the group Tsoncho Ganchev.
The other goal of the law is for 24-hour pharmacies to become part of the National Pharmacy Card, added his colleague Margarita Gencheva.
To the warnings about possible misuse of medicines from the machine, Prof. Andrey Chorbanov from ITN replied that even now he can go to the pharmacy and buy 10 packs of aspirin without anyone asking what they are for or warning him that if drink a lot, they are toxic. Even in the villages, where people have nowhere to buy medicine, the procedure is now as follows – someone, including the mayors, goes to the city and fills a bag with medicine for everyone. Pills of first necessity are also sold in some village shops, the immunologist repeated the arguments with which the project passed a week ago. “The licensing regime will be like that of pharmacies. The medicines that will be in the vending machines, in most European countries, can be bought in the supermarket”, Chorbanov added.
In yesterday’s “war” between politicians and pharmacists, the pharmacists sided with PP-DB. The head of the parliamentary health commission Alexander Simidchiev from “Democratic Bulgaria” supported the digitization of the health system, but not in a “hasty, knee-jerk, pre-election” version.
“The elderly will not be able to handle some of the things that need to be done with the vending machines because they are new technology. The vending machine costs BGN 180,000.” , he explained. Probably Dr. Simidchiev is referring to the model used in Italy and some other countries in the EU – the machine has special software that connects to the patient’s health file and only then “allows” him to buy the requested medicine. If we are talking about machines that dispense prescription drugs, they must necessarily have a video link with a pharmacist, Simidchiev insisted.
Medicines in the devices must be renewed, their expiration dates must be monitored, and this cannot be done without coordination with pharmacists, he reminded. Therefore, he insisted that a working group be created in which this bill would be discussed in detail.
Pharmacists also disagree with the thesis around which all political forces have united – that there are not enough pharmacies in Bulgaria. In our country they are 3,266, or one in 2,135 people. And the National Pharmacy Card has set that 3,230 people must have a pharmacy, explained the head of the Bulgarian Pharmaceutical Union, Dimitar Malinov. “In EU countries, there is one pharmacy per 4,122 people – in Bulgaria there are twice as many pharmacies as the EU average. 97.8% of the population has access to a pharmacy, which is about 30 minutes away,” he added.
And in just 4 months after the adoption of the new methodology for financing pharmacies in remote or hard-to-reach places, 6 new ones were opened.
The Union of Pharmacists insists that licensing of pharmacies be done on a demographic basis. And only companies that can provide all elements of pharmaceutical care should receive such a
A company wanted to invest BGN 20 million in vending machines 4 years ago.
As early as 4 years ago, an attempt was made to introduce vending machines for the sale of medicines in our country. At the end of September 2020, the then newly registered company, Pos Pharma, announced its intention to enter this business with an innovative project for a virtual pharmaceutical customer contact center.
The company announces that its goal is to provide vending machines in populated areas where there is no permanent access to pharmacies. The idea is that the vending machines will also offer medicines requiring a prescription, but the service will be carried out by pharmacists through a direct connection and thus sales will be controlled. The company’s intention is to invest nearly BGN 20 million in the project.
It even receives approval from the Council of Ministers, through a memorandum for a priority investment project.
The project, which the Ministry of Economy certified, is under the Investment Promotion Law, providing for an RND center and the development and implementation of specialized software. The certificate does not apply to vending machines, as the ministry does not support projects in the commercial sector, explained Lachezar Borisov, the Minister of Economy in the third “Borisov” cabinet at the time.
And the then Minister of Health Prof. Kostadin Angelov commented that the idea was to create jobs and ensure access to medicines in places where there are no pharmacies. However, the contractor company withdrew the project because it did not approve the opinion of the Ministry of Health that the devices should offer only medicines without a doctor’s prescription. Prof. Angelov reminds that there are such vending machines in the USA and Canada, but they are located in social institutions.
The Ministry of Economy coordinated the intention of the investor with the Ministry of Health, in the end the Minister of Health defined the project as unsustainable. After a meeting of the two ministers with Prime Minister Borissov, the decision of the Court of Justice was canceled, and the company withdrew the submitted documents.
Even then, pharmacists were categorically against the sale of drugs from machines on the grounds that it was dangerous for patients.