Pharmacies: the viability of a country's infrastructure
Some people will be surprised to hear a pharmacy organization talking about productivity, competitiveness, dimensions, and business viability. But it is precisely now when we must do so with more clarity than ever. We live in times of upheaval and uncertainty in supply chains and, not least, at the start of the conflict in the Middle East, the European Medicines Agency warned that persistent logistical difficulties could cause shortages of ingredients, medicines, or healthcare products.Community pharmacy is part of one of the densest and most accessible proximity pharmaceutical health models in Europe. In Catalonia and Spain, the vast majority of the population (98.8%) has a pharmacy within a few minutes of their home. This capillarity is no coincidence: it is the result of a model that combines an assistance vocation, territorial roots, and sustained business effort over decades. Behind each pharmacy office is – in addition to a health establishment – a micro-enterprise, a self-employed person, a human team, and a structure that generates employment, assumes on-call duties, maintains proximity services, and guarantees health accessibility every day of the year.
However, this balance is increasingly fragile. In recent years, pharmacies have had to absorb continuous increases in energy, labor, logistics, and technological costs, as well as new administrative and regulatory requirements. All this in a sector where drug prices are regulated and, decree of reference prices after decree, are falling, and where the ability to pass on these increases is non-existent.
This is an essential element of the debate: pharmacies do not compete by lowering wages or reducing quality. On the contrary: the quality of the model depends precisely on its professionals, its accessibility, and the continuity of care they offer. Therefore, when we talk about the economic sustainability of pharmacies, we are not just talking about profit and loss accounts: we are talking about social, territorial, and health sustainability.
Without business viability, there will be no capacity to maintain low-demand on-call services, professional services, stable and better-remunerated teams, nor technological investments. Without sustainability, there will be no generational succession nor capacity to maintain a balanced network throughout the territory. And this particularly affects micro and small businesses, which are the vast majority of the Catalan and Spanish pharmaceutical sector.
The real debate, therefore, is not just whether to improve working conditions or strengthen healthcare quality. Obviously, yes. It is how we make it possible for this to be sustainable over time.
We need a regulatory environment that understands the reality of small healthcare businesses and does not continue to accumulate bureaucracy, rigidity, and costs without considering their real capacity to bear them. We need policies that help modernize, digitize, and strengthen the operational capacity of pharmacies, not only so they are more efficient, but so they continue to be accessible and close.
It is not protectionism nor a defense of privileges: proximity has growing strategic value. The pandemic, supply problems, or risks associated with external dependence or those derived from climate change have highlighted the importance of having a distributed, resilient healthcare network rooted in the territory.
The community pharmacy network is an essential infrastructure for the country, a model that is probably only fully appreciated when it fails. Catalonia needs to continue investing in a professional, accessible, and viable pharmacy network. Because the economic sustainability of pharmacies is not incompatible with their social function. It is precisely the necessary condition for this social and healthcare function to continue to exist.
