The Ministry of Social Affairs says many communities lack a pharmacy entirely or have only limited hours, leaving patients — including those at nearly 60 family health centers — without local access. The number of working pharmacists is also shrinking, with more than half already over age 50.

Minister of Social Affairs Karmen Joller (Reform) said the aim is to ensure people can get essential medicines even in small communities or after hours — including on weekends.

"A self-service pharmacy would be a practical solution," she said, noting that customers would still need access to a licensed pharmacist, for example via remote video link.

She noted that a self-service pharmacy pilot in Rapla showed people would gladly use the option.

Under the ministry's concept, a self-service pharmacy would function as part of a regular community pharmacy. Customers would choose a medicine from the kiosk, identify themselves using their ID card, Mobile-ID or Smart-ID an ID-card, then speak with a pharmacist online.

The pharmacist would check prescriptions, advise on use and approve the purchase before the kiosk dispenses the drug.

Pilot project already a success

The model could offer common over-the-counter (OTC) and prescription medications in locations where maintaining a full pharmacy isn't feasible. Such kiosks could also offer access after hours in the evenings, on weekends — and even around the clock.

The legislative intent notes that several issues will require clear legal guidelines, including where such kiosks can operate without undercutting existing pharmacies, what quality standards video consultations must meet and how cybersecurity will be handled.

Which medications can be dispensed via self-service kiosks would also need to be regulated.

Estonia has already tested a limited version of the system. A 2023 pilot in Rapla allowed the self-service pharmacy kiosk to dispense OTC drugs with optional video consultations. The technology worked and customers were eager to use it, but current law restricted the kiosk to existing pharmacy premises and hours, preventing true round-the-clock testing.

A separate proposed change would let pharmacies contract out the preparation of custom-made, or compounded, medications. Today, only about a dozen pharmacies regularly provide compounding services, while others must maintain equipment and space they rarely use.

Under the plan, customers would still pick up their compounded medication from the pharmacy they first visited, but production would shift to properly equipped pharmacies with the proper expertise.

Pharmacist: Online pharmacies would be better investment

Some pharmacists are skeptical of the ministry's self-service pharmacy plans.

"First, we need to ask what problem it is we're solving," said Karin Alama-Aas, head pharmacist for Tallinn Emergency Medical Service (TEMS).

Kiosks could make sense in remote areas like the island of Kihnu, where no pharmacy exists. "But if we put them in cities where pharmacy services are already widely available, I see no reason we should spend money on this," she added.

Funding is also a concern. In a small community like Kihnu, annual sales would be around €30,000–40,0000, leaving profits in the low thousands — far short of a kiosk's own price tag. "Who would cover that investment?" Alamaa-Aas asked.

She noted some areas lack pharmacies simply because demand is too low, begging the question of how realistic or practical self-service pharmacy kiosks really are.

Tapping into the potential of existing online pharmacies, Alamaa-Aas suggested, would make more sense.

"People can already order medicines for home delivery or to a package terminal, provided the drugs' storage requirements allow," she said. "It might make more sense to develop dispensing kiosks for online pharmacies designed for safe medicine storage — like Omniva or other package terminals but for drugs."

Given how small margins are and how challenging it already is to keep a pharmacy viable at all, she added, there's no justification for introducing yet another costly system beyond pharmacies' means to maintain.

The Ministry of Social Affairs will decide its next steps once public feedback on the proposals has been reviewed.

--

Follow ERR News on Facebook and X and never miss an update!