Pharmacists value positively that the Council of Ministers updates aid for small apothecaries -from towns with a maximum of 1,500 registered inhabitants- with compromised economic viability
Of the more than 22,000 pharmacies that exist in Spain, some 4,500 are in rural areas. Of that number, just over 2,100 are in towns with fewer than 1,000 inhabitants. The continuity of these offices, as the Spanish Society of Rural Pharmacy (SEFAR), is seriously threatened. There are many that have closed in recent years. For this reason, SEFAR celebrates that, this very week, the Council of Ministers has approved the Modification of Royal Decree 823/2008 that updates the aid for those small apothecaries that are in compromised economic viabilitythe calls VEC pharmacies. A positive measure, says the president of the scientific society, Jaime Espolita, to El Periódico de España, from the Prensa Ibérica group: “That they have gotten down to work seems worth mentioning.”
Nucleus pharmacies with a maximum of 1,500 registered inhabitants will benefit from the increase
The modification of the royal decree –by which the margins, deductions and discounts of the distribution and drug dispensingupdating upwards the compensations received by pharmacies VEC– supposes that they will benefit from the increase of 17.5% corresponding to the application of the corrective index of the margins, the pharmacies of centers with a maximum of 1,500 registered inhabitantsor in other municipalities “in which the competent authority delimits and designates as risk to have adequate coverage or access to pharmaceutical services”, as explained by the Ministry of Health.
What the government wants is guarantee pharmaceutical provision in rural areas at risk of depopulation, in emptied Spain. Among the requirements to be able to access the aid is the fact that the annual sales of pharmacies must not exceed 235,000 euros in the fiscal year corresponding to the previous calendar year. Thus, from the current maximum 833.33 euros that a VEC pharmacy can receive per month, it would go to 979.16 euros. In addition, among other requirements, the pharmacy must have provided its services during the 12 months of the preceding calendar year.
In Spain, just over 3% of pharmacies (713) are affected by the corrective index. Of the total offices potentially benefiting from the application of this marker, 80.22% (574) are in municipalities with less than 1,500 inhabitants.
a positive move
“It seems to us a positive measure as long as the Administration is aware of the viability problem of the rural pharmacy and, with all the problems that currently exist around health, the fact that they have gotten down to work with it seems worthy of mention”, declares the president of SEFAR when this newspaper asks him for an assessment of the approval Jaime Espolita owns a pharmacy in Cabrillanes (León), one of those towns with less than 1,500 inhabitants (has less than 800).
Espolita has been for years launching an SOS for apothecaries in unpopulated areas. Because, he explains, “what was approved is still an update of the compensations based on the CPI, something that had not been done since the approval of the initial royal decree.” What he does consider to be of special importance “is that this margin correction factor be applied only to rural pharmacies or those located in underprivileged areas since, until now, it was applied equally to any type of pharmacy, taking into account as a criterion only the annual billing of that pharmacy“.
“The closure of a pharmacy in an isolated population does not have the same consequences, in terms of public health, as one in an urban or semi-urban area,” warns the president of SEFAR
With this, the Administration “makes it clear which pharmacies are the ones it considers essential when it comes to guaranteeing cohesion and equality in access to medicines.” From SEFAR, he adds, they have “great respect for all our colleagues and we consider that the work carried out by the community pharmacy is excellent, but the truth is that the closure of a pharmacy in an isolated rural population does not have the same consequences, in terms of public health, as the closure in the urban or semi-urban“.
Rural pharmacists complain of an excessive number of on-call services or the inability “to even minimally reconcile personal and professional life”
The latter has always been a claim of SEFAR: the rural pharmacy not only has “a problem of economic infeasibility derived from a compensation model that is inconsistent with our planning model, but other types of penalties are added”. The president of rural pharmacists He cites the excessive number of on-call services -of up to 6 months a year-, the total absence of services in their towns or the absolute inability “to even minimally reconcile personal and professional life; these facts that other types of pharmacies do not suffer“.
“We have never understood that they were not considered essential and measures were established to guarantee their subsistence,” they say from SEFAR
And it abounds: if we add to this that these pharmacies “are the only justification for our restricted model of opening pharmacies, we have never understood that not considered essential and measures were established to guarantee their subsistence”. The truth, admits Jaime Espolita, is that it seems “that the Administration has understood this fact and has realized that It is not possible to legislate in the same way for all in a sector as heterogeneous as ours”.
The Requejo pharmacist, in Zamora
Since requejobarely 150 inhabitants, in the Zamora region of Sanabria, where he runs the pharmacy, Elena Amaro also values the regulations positively. Zamora, describes Amaro, has 82% rural pharmacy and, with data at the end of 2021, there were 91 pharmacies in nuclei of less than 500 inhabitants. In the vast majority, only the owner works. Amaro, for example, has to do the distribution of medicines through the towns near Requejo. He likes to call it ‘home pharmaceutical care’, because it is not just and exclusively a question of bringing the bag of medicines to the patients, but of explaining to them how to take the new ones that have been prescribed, clearing up doubts…
Treatment of pharmacists with its neighbors it is very close. They know their illnesses and their treatments. Therefore, in line with what the president of SEFAR points out, Elena Amaro also positively values the new aid approved by the Government but, she qualifies this newspaper, “we need structural measures so that the rural pharmacy remains” because, she adds, They have some peculiarities that offices of larger populations do not have: low turnover, high guard loadabsence of services, isolation…
“What our society aspires to is the establishment of measures –changes in remuneration model, adding the payment of professional pharmaceutical services and depending to a lesser extent on the prices of the medicine- that make it unnecessary to resort to corrective factors of the margin, subsidies or aid. We think it would be beneficial for the whole industry“, concludes Jaime Espolita.