Rural Chemists Under Threat

With imminent changes to the availability of non-prescription drugs, and with pressure from the European Union to open up the profession, the future of rural chemists looks uncertain. Whilst residents from the UK and USA will be familiar with being able to buy self-service non-prescription medications from corner shops and supermarkets, 763(as well as from chemists), there is far greater regulation in France. There are no chemist chains across the country, and only qualified chemists are entitled to dispense non—prescription medicines, which are kept behind the counter, generally in closed drawers, and only available on demand. If you enter a chemist for cough mixture, or paracetamol, without a prescription, you might well be interrogated by the chemist, or a member of their staff, before being offered the product. It is quite possible you would not be offered a choice of product, nor would you necessarily know the purchase price, which are rarely displayed.

The Government have now decided that there should be greater availability and transparency in the sale of non-prescription medicines, with chemists being given the right (but not obliged) to display the products on open and accessible shelves in their premises.

The main objective of this change has little to do with consumer protection, but more an attempt by to persuade patients to ‘auto-medicate’, and thereby reduce the burden on an overstretched health service budget. As part of this exercise, last year the Government decided that some prescription 'branded' drugs they considered ineffective or expensive would simply not be reimbursed by the health service. Instead, patients would be expected to use generic alternatives, or pay for the drug themselves. This is now being followed up by making a wider range of up to 3,000 medicines available on self-service through chemists. Whilst these medicines would then be available without prescription, most would also continue to be available on prescription. There is already evidence that a relaxation of Government controls is resulting in a big increase in the prices. The price of some of the branded medicines no longer eligible for reimbursement, but still often requested by patients, has risen by over 100%. Chemists deny that they are profiting from these increases, which they say is the result of new wholesale prices being imposed upon them by the drug manufacturers, a view that seems to be borne out by the evidence. The prospect of a loosening of the regulations on the sale of non-prescription medicines has already begun to excite the appetite of the big supermarket chains, who are arguing that the monopoly of chemists should be broken. They claim that by doing so they should be able to reduce prices by an average of 25%.

The French Government is already under threat of legal action from the European Commission for the protective nature of existing regulations, which prevents the entry of external capital into pharmacies, thereby preventing the development of chemist chains across the country, as occurs in most other countries.

The French Attali Commission on Growth has also stated that the profession is one that must be opened up. France has around 23,000 independent chemists, none of whom are permitted under present regulations to operate more than one outlet. Thus far, the Minister of Health has stated there will be no change in the structure of the profession, but many feel that it is only a matter of time before supermarkets get a slice of this lucrative business. Whither, then, the rural chemist?

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