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PHARMACY

Sweden completes pharmacy sell-off

Sweden has secured buyers for some 465 pharmacies up for sale as part of the demonopolization of the country's retail drug market.

Sweden completes pharmacy sell-off
Social affairs minister Göran Hägglund presents new Apoteket symbol, 19/10/09

Together, the four new actors will control more than half of Sweden’s around 900 pharmacies, which were previously all owned by the state-run Apoteket monopoly. In order to facilitate their sale, the 465 pharmacies up for tender were subdivided into eight clusters by Apoteket Omstrukturering AB (OAB), the company formed to oversee the restructuring process.

Eva-Britt Gustafsson, managing director of OAB, explained that the four buyers would help set the stage for a well-functioning Swedish pharmacy market.

“We feel that this creates a good market structure made up of a number of actors with varying emphasis and geographical coverage,” said Gustafsson in a statement.

Apoteket AB will continue to operate around 300 pharmacies, while the country’s remaining pharmacies will be run by smaller private operators.

The combined sale price for the eight clusters amounted to 5.9 billion kronor ($857 million), as four parties swooped to control a major share of the re-regulated market, according to a statement released on Monday by OAB.

The sale price exceeded expectations, said OAB chairperson Birgitta Böhlin.

“The aim of the pharmacy reform is, among other things, to safeguard the secure provision of pharmaceuticals at low pharmaceutical prices,” said Böhlin, speaking at a Monday morning press conference.

Apoteket Hjärtat, owned by private equity firm Altor, is to be become the largest actor on the market having bought two clusters comprising 208 pharmacies, with a turnover of 7.1 billion kronor and 1,500 employees.

Kronans Droghandel Retail AB, a company jointly owned by Oriola-KD

Corporation and Kooperativa Förbundet (KF), acquired 100 percent of the shares in cluster 2, officially known as Pharmacy Company Sweden 2 AB, which consists of 171 pharmacies with a turnover of 4.4 billion kronor and 930 employees.

Medstop Holding AB, owned by Stockholm-based private equity firm Segulah, secured the purchase of clusters 3,4 and 5, which together comprise 62 pharmacies with a turnover of 3.1 billion kronor and 660 employees.

Swedish investment giant Investor has also acquired a share of the pharmaceutical pie through Vårdapoteket i Norden AB, a company it owns with fellow Swedish firm Priveq. Vårdapoteket i Norden AB has laid claim to clusters 6 and 7, which consist of 24 pharmacies with a turnover of 1.4 billion kronor and 230 employees.

The share transfer agreements are subject to the approval of the Swedish Medical Products Agency (Läkemedelsverket) and the country’s competition authorities.

As of November 1st, Swedes wanting to buy non-prescription drugs can do so at selected stores, including some gas stations and grocery shops.

Firms could start operating pharmacies under their own brand names “sometime early next year, maybe January or February,” Jebsen said, adding the acquisitions still had to be approved by the country’s competition authority and its medical products agency.

The Swedish government has previously argued that putting an end to the Apoteket monopoly would improve the availability of medicines for customers in the form of more pharmacies and longer opening hours, and create downward pressure on prices as more providers entered the market.

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HEALTH

EXPLAINED: Why does France have so many pharmacies?

One of the first things newcomers notice about France is the preponderance of pharmacies - instantly recognisable by their illuminated green cross signs - in every town, city and even some villages.

EXPLAINED: Why does France have so many pharmacies?
Over-the-counter medicines in pharmacies. Photo: Guillaume Sauvant/AFP

They are one of the things that make the French high street distinctive – the regular illuminated green cross of the pharmacy which helpfully also displays the time, date and temperature, but how does the economy sustain so many of these businesses?

How many?

Although pharmacies are lot more prevalent in France than many other countries, the French are not the European leaders in this field.

The most recent data on pharmacies shows around 21,000 in mainland France.

But an EU comparison from 2017 shows that France had 33 pharmacies per 100,000 people, a respectable number but not far ahead of the EU average of 29 and miles behind front-runner Greece, which has an astonishing 88 pharmacies for every 100,000 people.

Graphic: OECD

In fact France has fewer pharmacies per head of the population than Greece, Spain, Belgium, Latvia, Estonia, Slovakia, Ireland and Poland. It is however well above the UK (which at the time of the data was still part of the EU) on 21 on Denmark which has just 7 pharmacies for every 100,000 people, which could make for quite long queues.

The places in France with the highest density of pharmacies are Paris and the départements of central France – although that probably relates more to central France’s low population density than an abundance of pharmacies. One third of pharmacies are in places with fewer than 5,000 inhabitants.

Overall the number of pharmacies in France is falling, from 22,514 in 2007 to 21,192 in 2017.

But is there enough business for them all?

Monopoly

One of the main reasons for the popularity of the pharmacy is that they are the only place you can buy certain things, thanks to restrictive French rules on over-the-counter medicines.

While in many countries you can buy headache tablets or paracetamol in a number of places including supermarkets, corner shops and service stations, in France drugs like Ibuprofen can only be bought at a pharmacy.

This is also true for things like cough medicine and cold remedies, so if you have a minor illness you need to head to the pharmacy.

There are also restrictions on ownership which mean that pharmacy chains are not allowed, although parapharmacies – which only offer non-prescription medicines – are often part of a chain.

Hypochondria

As well as selling over-the-counter products, pharmacists also dispense medication prescribed by doctors and here French doctors and their patients keep them busy – a study in 2019 showed that 90 percent of doctors’ appointments result in a prescription and the average prescription is for three or more items.

READ ALSO Why are the French so keen on taking medicine?

The French are among the most medicated populations in Europe and a generous healthcare system means that most prescriptions are reimbursed, so patients are unlikely to hesitate before filling a prescription that their doctors give them.

Pharmacies in France usually also sell a wide variety of homeopathic remedies which are extremely popular, although from 2020 the government has stopped funding these.

Pharmacies have been a key part of Covid testing in France. Photo Guillaume Guay/AFP

Medical access

Another reason that French people love their pharmacies is that they are really useful. Every pharmacy or parapharmacy has at least one trained pharmacist on the premises who as well as dispensing medicines can give medical advice on a range of ailments.

They are particularly useful in the growing number of ‘medical deserts’ where there are not enough doctors for the local population and also open in the evenings and at weekends. Pharmacies in small towns or city neighbourhoods often have a rota so that at least one is open on a Sunday.

They also offer a number of extremely useful services such as dispensing the winter flu vaccine and – from March 15th – the Covid vaccine, while if you have been mushroom picking, you can take your haul to the local pharmacy to check that you haven’t picked anything poisonous. 

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