Bill allowing Estonian hospitals to buy medicines direct from EU stuck in parliament
A bill to grant hospitals the right to buy medicines directly within the EU has stalled at the Riigikogu after the government change earlier this year.
The current rules allow hospitals to purchase medicines only from a few major pharmaceutical wholesalers operating in Estonia.
For several years now, hospitals have wanted the option to source medicines and their input materials directly from European suppliers, but have faced pushback from the wholesalers and also pharmaceutical lobby groups.
Teet Torgo, CEO of the association of pharmaceutical wholesalers (Ravimihulgimüüjate liit) told "Aktuaalne kaamera": "Since the majority of hospitals in Estonia belong to the public sector, the side effect of the change would essentially be the nationalization of the hospital medicines sector – up to a third of Estonia's pharmaceutical sector."
According to Torgo, hospitals would gain wholesalers' rights, yet they would not have to fulfill all the obligations imposed on pharmaceutical wholesalers in Europe.
Kristjan Kongi, head of the pharmacy at the North Estonia Medical Center (PERH), a major hospital in Tallinn, rejected this claim.
"The goal of a hospital pharmacy is certainly not to engage in wholesaling. A hospital pharmacy is intended to ensure the hospital's continuity of supply of medicines," he said.
Kongi said the desired change is mainly meant for special cases, when a new drug is involved or when it is needed urgently.
For instance, last summer, the Tartu University Hospital was unable to purchase an epilepsy medicine from as nearby as Riga. The drug was at the time unavailable in Estonia, due to supply chain disruptions.
The bill addressing the issue and granting hospitals the right to buy direct had been met with opposition by Eesti 200. Just over a year ago, it reached the Riigikoug for processing, where it has been mired ever since.
Signe Riisalo (Reform), chair of the Riigikogu's social affairs committee, said parliament was waiting for a European Commission opinion, but noted the EU and domestic rules do not favor the à la carte purchasing of drugs.
"Hospitals must comply with all European and national rules just as wholesalers who import medicines do. This means that the rules are unreasonably strict for a hospital which imports very small quantities of highly specific medicines primarily for its own patients," Riisalo said.
According to the state Medicines Agency (Raviamet), under harmonized EU requirements, a wholesalers' license is required for those who acquire medicines, presupposing the intention of marketing them in bulk.
The amending bill however would not give medical institutions the right to do this, but would instead create options for hospitals to procure medicines directly from a pharmaceutical wholesaler in another EU member state or within the economic area.
The Ministry of Social Affairs is sponsoring the bill. It stated in a written response to ERR that the issue of hospital pharmacies is currently on hold. The matter was not included in the government's action plan when the current Reform-Eesti 200 coalition agreement was drawn up in spring, meaning it is also not on the ministry's work plan.
According to the Medicines Agency statistics, sales to hospital pharmacies account for nearly €129 million.
--
Editor: Andrew Whyte, Marko Tooming
