The myth of "excess pharmacies": why Ukraine should not reduce its pharmacy network

In Ukraine, statements about an “excessive number of pharmacies” and the need to reduce their presence in the market are periodically heard. At the same time, when making such statements, no one thinks about the losses for the patient or the state. UNN investigated whether there are really many pharmacies in Ukraine and what is the density of pharmacy outlets in European countries.

When a critical health-related situation occurs, each of us goes to the nearest pharmacy. And if the necessary drug is not found there, the question immediately arises of where the nearest point is where it or an analogue can be found. 

In such a situation, many pharmacies in one area are a good thing, aren’t they? 

And if you look at the situation not from the patient’s point of view, but from the state’s? Each pharmacy pays taxes, and also brings money to other businesses, for example, by renting premises. In addition, the pharmacists who work there are employed people who receive a salary and spend it on their needs. To simplify significantly, all together it is the economy.

European experienceAccording to research by the World Bank, in 2019-2021, the number of pharmacies in Ukraine averaged about 23 points per 100,000 population, depending on the region.

It is clear that in 2022, Russia’s full-scale invasion of Ukraine made its adjustments. Millions of Ukrainians, in search of safety, were forced to go abroad. But along with this, some pharmacies also ceased their work – somewhere the owner left the country, someone could not cope with the crisis, some of the points were destroyed as a result of enemy shelling. The latter is especially relevant for frontline territories.

In areas close to the front in Donetsk, Luhansk, Kharkiv, Sumy, Kherson, pharmacies are either bombed and have not recovered, or are forced to cease their work due to the proximity of hostilities. Only points of large chains that have the financial resources and are ready to maintain unprofitable pharmacies are being restored in relatively safe cities.

The main argument of those who voice accusations about the large number of pharmacies is that there are significantly fewer of them in Europe compared to Ukraine. But this is manipulation.

According to research, on average, there are about 28 pharmacies per 100,000 population in OECD countries (Organization for Economic Cooperation and Development, which unites 38 countries, including most European Union states, the USA, Canada, Japan, South Korea, Australia, and other economically developed countries).

For example, in neighboring Poland, there is one pharmacy for every approximately 3,000 inhabitants. This is approximately 36-37 pharmacies per 100,000 population. In Spain, there is one pharmacy for slightly more than 2,000 inhabitants.

Overall, the average figure for the European Union is one pharmacy for more than 3.2 thousand inhabitants.

At the same time, according to data, in 2022, Italy had 80,018 practicing pharmacists, Spain — 58,800, France — 61,900. Most EU countries have approximately 50-110 pharmacists per 100,000 population.

Access to social programsThese data confirm that the pharmacy network in Ukraine is not excessively large compared to European countries. Perhaps it is even slightly smaller than in Europe, but there are definitely not too many of them.

It should not be forgotten that Ukrainian patients have a wide choice and quick access to treatment. Today, key social initiatives in the field of healthcare are implemented through pharmacy chains: the “Affordable Medicines” program, insulin and other state programs for drug price reimbursement. Therefore, the wider the network of pharmacies, the easier it is for Ukrainians to use such programs. Limiting the number of pharmacies would lead to millions of patients being left without state-guaranteed medicines near their homes.

At the same time, it should not be forgotten that, according to data from the Ministry of Health, 89% of Ukrainian villages do not have stationary pharmacies at all. People are forced to travel dozens of kilometers to buy the necessary medicines.

As in the case of frontline territories, pharmacies in villages are not profitable, and therefore only large chains that can afford to maintain such points at the expense of more profitable ones in large cities can enter here.

Moreover, large chains can offer patients lower prices and various bonus programs due to their own logistics and wholesale purchases. In addition to providing jobs, chains regularly conduct training for pharmacists. At the same time, an extensive network of pharmacies encourages competitive struggle for the buyer, and here not only more favorable offers, but also service come into play. So, in the end, the patient wins, who can choose where to buy medicines.