Analysis of the Effectiveness of the Pharmacy Network

Abstract

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...

Ethics and Business in Community Pharmacies – A Framework for an Ethical Dialogue

“…On the other hand, pharmacists' employers should develop organizational cultures that support team development to ensure a good working environment and quality of pharmaceutical services [10]. Regarding dispensing complementary medicines, it has become a common practice in many countries to increase sales in community pharmacies, more or less accompanied by counselling [9,11,16,17]. Indeed, the explosion in the number of such products on the market makes it difficult to keep knowledge up to date, even by professionals such as pharmacists, used to search and select proper scientific information.…”

“…In fact, the extent to which pharmaceutical companies will assume their social and environmental responsibilities will also reflect the success of the ethical dialogue between the stakeholders [20]. The agreement of common training programs and the commitment to implement common actions have also been recommended by other authors, who emphasized the necessity of continuous efforts for ethical professional development of pharmacists, namely the creation of a framework of persuasion and resilience in the context of financial pressures, both in developing countries [4,8,9,11,22,24] and in more advanced countries, especially where pharmacists' roles in community pharmacies are expanding [1,5,18,19,26]. In the process of establishing the content of common training, providing them in an experiential context, and assessing their results based on the skills and abilities acquired, collaboration with academic institutions could be useful [1,5,8,16,26], which would constitute a long-term beneficial partnership for everyone involved, as well as for the future of pharmaceutical education.…”

“…Ethical competencies acquired by pharmacists during their education are heavily challenged by the business environment in which they work, even in the community pharmacy, "particularly where there are corporate values and reward systems in operation" [26]. Moreover, sometimes insufficient training for ethical decision-making in practice [1] makes them even more vulnerable to financial pressure, some of them being pushed into "moral distress" [8,11] or suffering a "crisis of professional identity" [9]. Indeed, a very competitive environment, such as that of community pharmacies, may exacerbate the pressure and conflicts between professional pharmaceutical ethics and employers' business interests [9,10,16,18,24,26].…”

“…Moreover, sometimes insufficient training for ethical decision-making in practice [1] makes them even more vulnerable to financial pressure, some of them being pushed into "moral distress" [8,11] or suffering a "crisis of professional identity" [9]. Indeed, a very competitive environment, such as that of community pharmacies, may exacerbate the pressure and conflicts between professional pharmaceutical ethics and employers' business interests [9,10,16,18,24,26]. The most frequent conflicts faced by pharmacists in the community pharmacies are related to the setting of sales targets by their employers [10,11,19,24], dispensing complementary medicines [9,11,16,17,19], making time for patient counselling [9,17,18] and collecting expired medicines from patients for proper disposal [3,21,24].…”

“…Indeed, a very competitive environment, such as that of community pharmacies, may exacerbate the pressure and conflicts between professional pharmaceutical ethics and employers' business interests [9,10,16,18,24,26]. The most frequent conflicts faced by pharmacists in the community pharmacies are related to the setting of sales targets by their employers [10,11,19,24], dispensing complementary medicines [9,11,16,17,19], making time for patient counselling [9,17,18] and collecting expired medicines from patients for proper disposal [3,21,24]. Dealing with such conflict situations frequently may have a major negative impact on the pharmacists' professional satisfaction and commitment to providing quality services to their patients [10,18,26].…”