engleski

Changes in Croatian Pharmacy in Last Decade

As a country in transition Croatia was faced with big challenges of the changes in the existing political and economical system. One of the key challenges was the transformation of ownership from state-owned into private property. The privatization of the health care system was approached with utmost care because of the risk and serious concern that quick radical changes might jeopardize the existing quality and accessibility of health care services. Therefore, a very specific privatization model of the health care system was chosen, as the initial part of long-term process – a leasing model for privatization of existing state-owned pharmacies and parallel opening of new pharmacies owned by the private legal-persons. Opening of the first community pharmacies owned by the private legal persons in the Republic of Croatia started in early nineties of 20th century. At the end of 1990, the first legislative Act on private initiative and private ownership within the Health Care System entered into force, whereas the first community pharmacy in private ownership was founded in January 1991. The Act from 1993 enabled the establishment of specific form of pharmacy chains, within the private ownership, as well. Accordingly, the owner of such a pharmacy chain does not have to be a pharmacist. Early in 1996, another Act on gradual privatization of the (340) state-owned community pharmacies was passed, by leasing a pharmacy to all employed pharmacists in the pharmacy. It was expected that such model of privatization would be realized in the period from 1997 till 1999. However, there is a wide gap between its present realization and the foreseen schedule; i.e. it has been considerably slowed down. The Ministry of Health has changed Spatial and the human resources standards for pharmacies, particularly for the private pharmacies for the period from 1991 till 1998, several times already. Positive regulations that are in force nowadays prescribe 85 m2 as the minimal area for a pharmacy, and at least one employed pharmacist for every single pharmacy. At the end of 1998, the proportion of community pharmacies in the private ownership amounted to about 58 % from the total number of community pharmacies in Croatia. At the same time, this part of community pharmacy in Croatia realized 53% of total financial trade within the branch. The problems which negatively affect operation of community pharmacies in Croatia today, especially the private sector, are: economic recession, insolvency of the state health insurance which is by far the most significant and the largest business partner in pharmacies and the only one health insuring institution in the country that insures about 60% of financial trade in public pharmacy. There is also incompleteness or imprecision in a part of the legislative framework pertaining to pharmacy and an inadequately low amount received by the pharmacy, for issuing a medication on prescription. This has also retarded the introduction of new trends such as pharmaceutical care into pharmacy practice and has also put to test the ethical principles of the profession. Total predominance of the private ownership within the public pharmacy sector in Croatia is unavoidable and only a question of time. Further, with the progress of privatization and with an opening of new public pharmacies, the Authorities should accept the requirement posed by pharmacists on respecting the general principles of the pharmacist's profession, among them also: "that one pharmacist may be the owner of only one pharmacy" and "that only a pharmacist may be the owner of a pharmacy".

Croatian pharmacy; privatization of pharmacy sector; leasing model of privatization

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