A spatial analysis to evaluate the impact of deregulation policies in the pharmacy sector: Evidence from the case of Navarre

Barbarisi, Ilaria; Bruno, Giuseppe; Diglio, Antonio; Elizalde, Javier; Piccolo, Carmela

doi:10.1016/j.healthpol.2019.08.010

Cited by 17 publications

(9 citation statements)

References 15 publications

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“…The three items were whether OTC medicines could be sold online or not, whether the selling of OTC medicines was allowed in the non-pharmacy retail, and last, if the establishment of pharmacy retail was subject to restrictions, such as the number of inhabitants, distance, etc. The restriction or lack of restriction of the establishment of pharmacies does have an impact on the accessibility of OTC medicines in countries, where non-pharmacy retail is not allowed, an example of their impact of them can be found in Barbarisi et al [ 26 ]. Regarding the online selling of OTC medicines, we find a clear picture of their availability online in 28 of the 30 countries, which differs from the prescribed medicines, where online selling is allowed in less than 15 countries and with several restrictions.…”

Section: Resultsmentioning

confidence: 99%

A quantitative classification of OTC medicines regulations in 30 European countries: dispensing restrictions, distribution, pharmacy ownership, and pricing systems

Vila

Buts

Jegers

2023

J of Pharm Policy and Pract

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Background This paper reviews the regulations of over-the-counter (OTC) medicines in 30 European countries with the goal of identifying the regulatory trends and clusters as of May 2022. Methods To that end, we reviewed the regulation that directly or indirectly might have an impact on OTC medicines. The data were gathered from the national legislation, reports from international organizations, and the existent literature. The 12 regulatory items obtained were classified into four categories: price, pharmacy ownership, distribution modes, and dispensing restrictions. In addition, these items were also employed in the cluster analysis. Results Pharmacy ownership is mainly private, and in the majority of countries, OTC medicines are not subject to any pricing system. Almost every country studied allows online selling of OTC medicines, and 16 countries allow non-pharmacy retail to sell OTC medicines as well. The dispensing restrictions applicable in pharmacy retail are similar in the countries studied: they rely on the staff, OTC medicines are placed behind the counter and the doses dispensed tend to be restricted. Concerning non-pharmacy retail, additional dispensing restrictions might be imposed, such as the establishment of buyers’ minimum age, the requirement of a pharmacist to supervise the operations, a regulation on the location in the store, and further restrictions on the package sizes, strength, or pharmaceutical form. The cluster analysis resulted in an initial division between countries that widely allow the sale of OTC medicines in non-pharmacy retail and countries, where pharmacy retail has an OTC monopoly. Based on the regulations, 7 subsequent groups were identified evidencing wide regulatory heterogeneity within the countries studied. Conclusions Our findings point out that OTC medicines are in general not subject to pricing systems, selling is allowed online, and ownership of pharmacies is mostly private. However, regarding dispensing restrictions, pharmacy chains, and establishment restrictions of pharmacies, we found heterogeneity that is also visible in our cluster analysis, since we identified 7 clusters.

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Section: Resultsmentioning

confidence: 99%

A quantitative classification of OTC medicines regulations in 30 European countries: dispensing restrictions, distribution, pharmacy ownership, and pricing systems

Vila

Buts

Jegers

2023

J of Pharm Policy and Pract

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“…Also, liberalization led to vertical and horizontal integration best observed in Norway and in the Netherlands, where large wholesalers owned 81% and up to 100% of pharmacies, respectively [34,35]. Geographical regulations are also supported by the analysis carried out in Pamplona, Spain, where different regulatory practices were compared with Sabadell's city [5]. The study of the effects of liberalization in Croatia [25] also supports the need for partial adaptation in the pharmaceutical segment.…”

Section: Ratiosmentioning

confidence: 88%

Analysis of the Effectiveness of the Pharmacy Network

Grega¹

2021

FARMACIA

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The legal framework for pharmacy has been frequently changed after the foundation of present-day Slovakia in 1993. The establishment of new pharmacies was regulated and based on geographical criteria in the past. This article aimed to evaluate the impact of geographical restrictions removal on the number of newly established pharmacies in Slovakia and assessed their financial performance in the period from 1998 to 2017. Selected financial indicators, demographics, and the number of inhabitants per community pharmacy have been assessed. 25% of community pharmacies in Slovakia showed a negative return on sales (ROS), total debt higher than the average of Slovak healthcare, and did not maintain the expected range of current liquidity status. Overall, 16% and 31% of pharmacies were unprofitable based on the Altman Z score and Index 05, respectively. While the number of inhabitants remained relatively unchanged, the number of community pharmacies doubled during the observed period. Based on the results, we designed models to decrease the number of pharmacies and increase the inhabitant/pharmacy ratio to improve pharmacies' financial performance. We propose to introduce regulating demographic criteria to establish new pharmacies based on our models. By regulating or reducing the number of pharmacies, it can be expected an increase in the offered pharmacy services. To maintain the quality and accessibility of pharmaceutical services in rural areas, providing financial support for community pharmacies could be an alternative. RezumatCadrul legal pentru farmacii a fost modificat frecvent după înființarea Slovaciei actuale în anul 1993. În trecut, înființarea de noi farmacii era reglementată și bazată pe criterii geografice. Acest articol urmărește evaluarea impactului eliminării restricțiilor geografice asupra numărului de farmacii nou înființate în Slovacia, precum și evaluarea performanței financiare a acestora în perioada 1998 -2017. Au fost evaluați indicatori financiari, date demografice și numărul de locuitori pentru o farmacie comunitară. 25% dintre farmaciile comunitare din Slovacia au prezentat o rentabilitate negativă a vânzărilor (ROS), datorii totale mai mari decât media asistenței medicale slovace și nu au menținut intervalul preconizat al lichidităților. În general, 16% și 31% din farmacii au fost nerentabile pe baza scorului Altman Z și, respectiv, a Indicelui 05. În timp ce numărul de locuitori a rămas relativ neschimbat, numărul farmaciilor comunitare s-a dublat în perioada analizată. Pe baza rezultatelor, am conceput modele pentru a reduce numărul de farmacii și pentru a crește raportul locuitor/farmacie în scopul îmbunătățirii performanței financiare a farmaciilor. În concluzie pe baza modelelor noastre propunem să introducem criterii demografice pentru reglementarea înființării de noi farmacii ceea ce va îmbunătății serviciile oferite. Pentru a menține calitatea și accesibilitatea serviciilor farmaceutice în zonele rurale, furnizarea de sprijin financiar pentru farmaciile comunitare ar putea fi o alter...

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“…For our analysis, we focus on the Campania Region, which is the second most populated region in Italy, with about 6 million of inhabitants (density of 425 inhabitants per km 2 ). To calculate the introduced indicators, we implement the following methodological steps (see Barbarisi et al 2019 ; Bruno et al 2020 ): Delimitation of the study region; Definition of the (multi-service) facility network; Demand representation; Distance matrix calculation. …”

Section: Description Of the Case Studymentioning

confidence: 99%

Geographical accessibility to upper secondary education: an Italian regional case study

et al. 2022

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In this paper, a spatial analysis is performed to measure students’ access to the upper secondary education system. Based on the definition of quantitative indicators, the adopted approach is applied to an Italian regional case by exploiting the capabilities of a GIS software and using census tracts’ level data. The obtained results highlight geographical patterns of inequalities in access among students and shed light on the least served areas. Further analysis shows that accessibility reflects the degree of urbanization within the study region and that geographical distances are actual barriers to rural students since they are not compensated for by either economic status or the availability of digital infrastructures. The study offers empirical grounds to inform the decision-making process toward equity-in-access oriented interventions. Longer-term actions, as the activation of new schools (network expansion), the activation of new programs (service expansion) or the redistribution of their supply among the current network (network reorganization), as well as mid-term ones, like offering economic support for students’ mobility, or reinforcing digital connectivity, emerge as relevant to mitigate social exclusion.

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A spatial analysis to evaluate the impact of deregulation policies in the pharmacy sector: Evidence from the case of Navarre

Cited by 17 publications

References 15 publications

A quantitative classification of OTC medicines regulations in 30 European countries: dispensing restrictions, distribution, pharmacy ownership, and pricing systems

A quantitative classification of OTC medicines regulations in 30 European countries: dispensing restrictions, distribution, pharmacy ownership, and pricing systems

Analysis of the Effectiveness of the Pharmacy Network

Geographical accessibility to upper secondary education: an Italian regional case study

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