engleski

Croatian pharmacy practice in the context of transitional changes

Establishment of the independent state as well as the transition of the political system and economy led to great changes in the organisation and functioning of pharmacy practice. Changes in legislation (1990 and 1993) allowed for the intensive privatisation process to start. Between 1991 and 1997, privatisation involved opening of new pharmacies, owned by pharmacists, or chains of pharmacies that might be owned also by other physical or legal persons. The process of transformation of state-owned pharmacies started only in 1997 by leasing such pharmacies to pharmacists formerly employed in them. This process does not follow the defined dynamics and is currently retarded. Since the pharmacy network is not adequately defined, opening of new pharmacies, notably in big cities, was not properly controlled. The Ministry of Health applied solely the demographic criterion (5000 inhabitants/1 pharmacy) to estimate whether opening a new pharmacy was justified. The number of community pharmacies has almost doublet since 1990 and 749 pharmacies (61% privately owned) are currently operative. On average, a pharmacy employs 2 pharmacists while the annual turnover amounts to about 0.6 million. Drug account for about 80% of pharmacy turnover while the annual per capita drug consumption is currently ca. 90. Most pharmacy activities (about 62%) involve dispensing prescription drugs to the national health insurance users. In 1994, the national health insurance introduced a point-system, rather than margin, for reimbursing pharmacy services. The current value per one prescription is 0.75 (7-8% margin). The margin for OTC drugs ranges between 30% and 35%, while the margin for overall turnover of a pharmacy amounts to 15-18%. Insolvency and delayed reimbursement by the national health insurance, along with the economic difficulties in Croatia in the last two years, threaten pharmacy practice. 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. Stabilisation of economy, health reforms and further democratisation, as well as amendments to pharmacy legislation, will more rapidly bring Croatian pharmacy practice closer to the model and standards of pharmacy organisation and operation in the European Union.

Croatian pharmacy; pharmacy practice; community pharmacy

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