Friday, January 11, 2008

Pharmacies for pharmacists only! Air companies for pilots only!

Our district traditionally has had one pharmacy. About a year ago, another one was opened. However, it was closed three or four months ago. I thought, apparently the consumer demand for pharmacy products in our districts isn't high enough to allow a second pharmacy.
However, when I went to the pharmacy yesterday to buy cold remedies for my husband and saw that it was closed, too, I understood something else was going on.
Bulgarian business in general is burdened by a myriad of regulations, rates and taxes. For pharmacies, there are even more of them because here buraucrats find it easy to claim that they are thinking about the patients' well-being. However, the predictable net result is that Bulgarian patients buy drugs at higher prices than patients in other European countries with much higher incomes. And keep in mind that in Bulgaria, unlike other countries, you typically pay out of your pocket 100% of the drug's price even if it is prescribed by a doctor and you have a perfect medical insurance. Worse, many drugs, including life-saving ones, aren't available in Bulgaria at all because the regulations and taxes make it impossible for manufacturers and pharmacists to profit from them, or simply because the manufacturer cannot cope with the grotesque paperwork required for the drug to be allowed for sale.
Right now, pharmacists are protesting about the latest attack on their profits by government (you can read details at Novinite). They complain they will be driven out of business and officials reply that this would be no disaster because Bulgaria now has more pharmacies per capita than other European countries. Eh well, I suppose other European countries have also fewer grocery stores and supermarkets, because the majority of people use their cars when shopping and prefer fewer but bigger shops. However, in a country where most people have no cars and will not have them in the foreseeable future, you just cannot say that it is OK if shops supplying an entire district go bankrupt. This enormously affects quality of life.
Now, the nearest pharmacy is located at about 1.5 km from my home. This is quite a long distance when the weather is bad or you have to walk through snow, as now. Worse, you have to walk through an underpass with stares which has no accessibility accommodations. I hate going there with the baby pram (just think about wheelchair users - it is absolutely impossible for them to climb down and up the stairs). So I decided not to do the journey.
In the evening, I told my mother in-law that the pharmacy has closed. She said, "I know. This happened three weeks ago, you just haven't mentioned until now. The owner has no Master degree in pharmacy, just a Bachelor degree. So the regulations ban him from owning a pharmacy. The same problem had the owner of the other pharmacy that was opened in the district last year. He also had to close."
Arrrrrgh! Indeed, one of the myriad regulations about pharmacies is that only Masters of Pharmacy can own them. Capital weekly commented that following the same logic, you must allow only pilots to own air companies! The regulation in question must have been introduced because of lobbying by pharmacists with Master degree.
I would say that these people are stupid and have the inability to think long-term that is typical for stupid people. They may be happy now for driving their competitors out of business, but as years pass, time will come for them to hand the business to their children. And then they may not be so happy, because not all children of Masters of Pharmacy will also succeed to acquire the degree!
Buraucrats give the usual explanation: "This is the practice in other countries." Why must we import every illogical thing that is practiced in other countries? I agree that the people who supply the drugs to the pharmacy and sell them to the patients should be pharmacists. But why the owner also? Master of Pharmacy degree needed to fill the tax forms?
The result, as we see, will be - many poorer people left without access to any pharmacy.

2 comments:

dokidok said...

Typical Bulgarian reality. Nothing changes. I am always very sceptic when other bulgarians are too excited about the new stores, bars and chalgateki(not sure about the spelling). At the same time the education, healthcare and lifestyle are the worst in EU. I will be more than happy to publish in my blog your interesting story(if you don't mind of course). My blog is medical so the story should be from a bulgarian hospital. I am sure there are lots of controversial cases.

Maya M said...

Thank you for the comment! You are free to re-post this, or any other my post. Perhaps you would be interested in my Oct. 7, 2007 post about a premature baby who died because of a blackout:
http://mayas-corner.blogspot.com/2007/10/end-of-life-in-pediatric-intensive-care.html
I actually don't work at a hospital - our Department of Biology belongs to the preclinical, not the clinical part of the Medical University of Sofia.