"Pharmacy desert": on the socio-economic consequences of reducing the number of pharmacies in Ukraine

For some time now, the idea of reducing the number of pharmacies has been voiced at various levels in Ukraine. Instead of developing healthy competition, it is proposed to reduce the number of pharmacies to one per district (or settlement) or to allow only pharmacists to open pharmacies, also limiting their number in the hands of one owner. The latter, in itself, will also lead to a reduction in the number of pharmacies. UNN investigated the consequences of implementing such initiatives.

One pharmacy per district and no alternativesMany countries have long been researching the concept of a “pharmacy desert” – an area where the time it takes to get to a pharmacy exceeds the time spent traveling to a supermarket. Even a developed country like the US faced a situation in 2025 where 17.7% of the population lives in such “deserts,” and another 8.9% relies on a single pharmacy.

Currently, 89% of villages in Ukraine do not have stationary pharmacies. These are millions of people who already live in “pharmacy deserts.” How many such “deserts” will form in cities if only one pharmacy remains per district?

And each such “white spot” on the pharmacy map means problems with access to vital medicines, and possible interruption of treatment protocols. This has already been understood in many developed countries, such as the US and the UK, where the state is trying to rectify the situation.

But in Ukraine, this seems to be understood only by ordinary citizens – UNN conducted a survey of Kyiv residents on how they feel about the initiative to reduce the number of pharmacies – people perceive it extremely negatively. They understand that this is not only a longer path to the pharmacy, which can cost health and even life, but also a decrease in competition, an increase in prices, a drop in the level of service, and a reduction in assortment.

This is also confirmed by sociological studies: 71% of respondents note that the more pharmacies there are in a settlement, the easier it is to find the necessary medicines. 66.8% of respondents also confirm that a larger number of pharmacies contributes to finding a lower price for medicines.

Local monopolistUkraine has already lost approximately 25% of the pharmacy market due to the war. Most of the losses concern temporarily occupied and frontline areas, however, now “desertification” can spread to relatively peaceful territories, and we are talking not only about rural areas, where access to medicines is already limited, but also about large cities.

The implementation of the “one pharmacy per district” concept will turn the “chosen” pharmacy into a local monopolist, which will dictate its terms to local consumers: if you don’t like the prices, go to another district; if you doubt the storage conditions, look elsewhere. The quality of service and the development of additional services are also questionable under such circumstances.

Economic lossesA significant reduction in the number of pharmacies will inevitably lead to economic losses in the form of reduced tax revenues to the state budget. Only 5 major players in pharmacy retail paid 4.5 billion hryvnias in taxes to the state budget of Ukraine in 2024. In total, the volume of tax revenues from retail trade in medicines was estimated at about 7.5 billion UAH. That is, we are talking about billions in losses. And add to this a significant reduction in jobs – and these are not only pharmacists, but also, for example, those who provide logistics. And also other related industries that receive a positive economic effect from the development of the pharmacy network.

As a result, reducing the number of pharmacies will cause a negative cascading effect: from rising drug prices and complicating physical access to them, to job losses and budget losses.