engleski

Development, Organization and Financing of Community Pharmacy in Croatia

Since Croatia gained independence in 1991, its whole health care system has been greatly changed. Significant problems, which had to be solved to ensure professional and business efficiency of the new health system, involved ownership definition and functional organizational interventions in the former irrational and obsolete model. Changes occurring in pharmacy were in part identical to those in other Central European countries in transition while differences were mainly due to a more liberal legislation as well as to conditions. Croatia has population of 4.8 million and land area of 56, 6000 km2. Its GNP per capita amounts to about US$3, 800. New legislation allows a pharmacy to be opened per 5, 000 inhabitants, at a distance not smaller than 500 m. Only pharmacists can be pharmacy owners. Pharmacy activities may also be discharged by health institutions owned by physical or legal persons. Pharmacy space requirement has been reduced from 115 m2 to 85 m2. The number of community pharmacies went up from 396 to 650 in the 1991-1996 period. New private pharmacies account for 40% while 60% are state-owned, most of them foreseen for privatization. The current status includes Croatia into the group of countries with relatively well developed pharmacy network (1 pharmacy per 7, 300 inhabitants), with an increasing number of private pharmacies. Croatia has 52 hospital pharmacies, which do not dispense drug to out-patients. These are not seen for privatization. The number of registered drugs were slightly increased in the 1990-1996 period and now amounts to about 2, 200. Under new legislation, the drug registration procedure has been adjusted to that in the developed European countries. The national pharmaceutical industry covers about 70% of vital drug requirements. The health insurance fund is fully state-owned. Proportion of drugs dispensed by community pharmacies to the debit of the health insurance fund was decreased from 70% in 1991 to about 60% in 1996. Sales of OTC drugs were increased in the same period. Economic effects based on changing services to the health fund are not adequate. Prices of OTC drugs and other products are formed freely (up to 35% margin) and this compensates pharmacies for the unrealized profit from the health insurance fund. Further development of community pharmacy in Croatia will be influenced by: passing of comprehensive legislation on state-owned pharmacies, additional graduate and post-graduate education of pharmacists for adjustment to market conditions and the new role of pharmacists in the pharmaceutical care system. Community pharmacists have their section within the Croatian Pharmaceutical Society and have to be members of the newly formed Croatian Chamber of Pharmacists. The vitality and long-standing tradition of Croatian Pharmacy will hasten its successful inclusion into pharmacy of developed European countries in both the professional and economic sense.

Community pharmacy; Development; Financing; Organization

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