A new report on the implementation of the “Pharmacy for Pharmacists” act (AdA) found that it led to a decline in the number of pharmacies and pharmacy outlets in Poland.
The 2017 amendment to the pharmaceutical law was designed to protect small, independent pharmacists from the expansion of large pharmacy chains. However, eight years later, the effects of this regulation raise concerns.
According to the report, authored by Prof. Michał Bernardelli and Dr Konrad Walczyk from the Public Finance Institute (IFP) for Lewiatan Confederation, the number of pharmacists in Poland decreased by over 2,600, with pharmacy outlets falling by 265.
The Supreme Pharmaceutical Chamber, however, highlights that the report overlooks the key objectives of the regulation. “The report’s findings are not surprising but represent a one-sided and simplified analysis of the complex processes occurring in the pharmacy market,” Konrad Madejczyk, the spokesperson for the Supreme Pharmaceutical Chamber, told Euractiv.
Pharmacy for pharmacists
The Polish pharmacy market has long been subject to stringent regulation aimed at protecting the interests of pharmacists and patients. One of the key pieces of legislation is the AdA, which was updated in 2023.
It is intended to ensure that pharmacies are run by qualified pharmacists, thereby safeguarding service quality and patient safety.
Moreover, the report highlights that these regulations primarily blocked new investments, resulting in a sharp decline in newly opened or acquired pharmacies, and therefore shrinking the market presence. Smaller operators, particularly in rural areas, were disproportionately affected.
The policy did not strengthen the position of independent pharmacists as intended, nor did it increase competition or improve pharmacies’ negotiating power with wholesalers and drug producers.
A significant outcome was reduced availability of medicinal products and medical devices, partly because the restriction on pharmacy chains limited consumer choice and pushed prices up. From 2018 to 2024, prices for non-reimbursed and over-the-counter medicines rose cumulatively by 50.7%, exceeding general inflation by 8.9 percentage points.
The report suggests that the Italian pharmacy deregulation model might offer a way forward. Italy experienced similarly slow growth in the number of pharmacies under strict regulations, which failed to meet the needs of an ageing population.
In 2017, Italy lifted ownership limits while maintaining demographic and geographic criteria, such as one pharmacy per about 3,300 residents and a 20% regional cap on pharmacy ownership by a single entity.
According to the authors, this deregulation poses no threat to medicine safety. They conclude that “projections indicate that even if all licensing restrictions were removed, competition would not decrease, and the market would reach a natural saturation point, primarily driven by Poland’s declining population.”
Pharmacy sector concerns
The Supreme Pharmaceutical Chamber disagrees with this interpretation of the data. They said that “The purpose of the law was to restore balance between the interests of patients, pharmacists, and the state by guaranteeing that pharmacies would be operated by those with professional qualifications and ethical principles, rather than merely economic calculations.”
The organisation argues that the AdA law effectively prevented the Polish market from being dominated by a few large capital groups, which in countries without similar restrictions have monopolised the market and forced smaller pharmacies to close.
“Currently, nearly 70% of pharmacies in Poland remain individual, family-run, or small pharmacist partnerships, precisely the model the law intended to protect. It is therefore difficult to claim the regulation has caused the market’s decline. Instead, it shielded it from domination by large chains,” Madejczyk explained.
Contrary to the report’s findings, the decrease in the number of pharmacies is predominantly attributed to economic factors, such as underestimated margins, rising employment costs, inflation, and unstable reimbursement policies, rather than the AdA law itself.
The Chamber views the proposed market deregulation in the report as a threat to patient safety and system stability. “Opening the market to non-professional capital, especially linked to wholesalers or international chains, risks the elimination of local pharmacies and making the market dependent on commercial decisions,” the spokesperson warned.
He emphasised the Chamber’s consistent stance: “A pharmacy should remain a public health facility, not merely a retail outlet.” He added that Poland’s current demographic and geographic rules align with those in several EU countries, including Germany, France, and Spain.
“Deregulation must be accompanied by measures strengthening pharmacists’ positions, stabilising the market, and ensuring fair economic conditions for operating pharmacies. This is the only way to guarantee patients sustainable and equitable access to pharmaceutical services across the country,” he concluded.
[VA, BM]
