Over the past 30 years, pharmacy services have become largely concentrated in larger urban centres. As a result, access to medicines in smaller regions has worsened, and round-the-clock services are lacking. Currently, on-call pharmacy services are provided in only three pharmacies across Estonia—two in Tallinn and one in Tartu.
According to Minister of Social Affairs Karmen Joller, medicines must be accessible to people regardless of whether they live in a large city or a smaller area.
"A machine will not replace a pharmacy, and that is not the goal. However, many people have experienced that when a pharmacy is far away or already closed in the evening, even a minor health concern can turn into a major problem," Joller said. "It is equally important that a person can obtain the necessary medicine even when it needs to be specially compounded or requires more complex technology. With these changes, we are giving pharmacies greater opportunities to cooperate and to better use the expertise of those pharmacies and hospital pharmacies with stronger compounding capabilities."
One of the proposed solutions is the introduction of pharmacy vending machines. This is a new service through which people can obtain over-the-counter medicines as well as prescription medicines based on digital prescriptions. A pharmacist or pharmacy technician will participate in each transaction via a video link, checking the prescription, verifying the suitability of the medicine, and advising the patient.
This means that the person will never be without professional support. The decision to dispense a medicine will always be made by a qualified pharmacy professional.
The machines will form part of retail pharmacies and are intended to complement the existing pharmacy network, not replace it. Safeguards will ensure that the machines do not become concentrated only in larger centres and that existing pharmacies can continue operating.
The amendment does not oblige pharmacies to adopt such machines. Each pharmacy owner will decide whether and how to implement these new solutions.
The organisation of compounded medicines will also change. In the future, pharmacies will be able to order the preparation of medicines from another pharmacy when needed. This means that medicines will mainly be compounded in pharmacies that have the required equipment and expertise. For the patient, the service remains the same, as the medicine will be dispensed at the pharmacy they first approached. The medicine moves, not the patient.
The draft also expands the role of hospital pharmacies in medicine compounding. Retail pharmacies will be able to order medicines from hospital pharmacies if they lack the necessary capacity. Hospital pharmacies will not be granted retail rights, nor will they be required to prepare medicines for other pharmacies.
This is particularly important, for example, when a patient receives a suitable medicine in hospital but it is not available in a retail pharmacy for home treatment. In such cases, preparation of the medicine can in the future be arranged through a hospital pharmacy.
The draft has been developed in cooperation with the Ministry of Economic Affairs and Communications' innovation programme Accelerate Estonia, and takes into account input from pharmacists, businesses, and the healthcare sector.
"Estonia must be a country where innovative and smart solutions do not remain merely ideas but reach people's everyday lives. The introduction of self-service pharmacies is a clear example of how a national innovation accelerator can help create space for new technologies and business models even in highly regulated sectors. If we want to be innovation leaders in Europe, we must consciously enable the development and adoption of such solutions," said Minister of Economic Affairs and Industry Erkki Keldo.
