In order to discuss the situation and highlight changes that are important to the sector and patients, various discussions are taking place in the public sphere between industry leaders and professionals, seeking to explain the reforms introduced by the Ministry of Health (VM), which closely affect pharmacists, pharmacies and pharmaceutical supply companies, in order to maintain public respect and understanding of the role of pharmacists in health care under the current circumstances, and to ensure that the main focus, namely patients and the pharmaceutical care they need, is not lost amid the confusion of goals and opinions.

The Executive Director of the Latvian Pharmaceutical Care Association (LFAA), Kristīne Jučkoviča, the President of the Latvian Pharmacists’ Association (LFB), Dace Ķikute, and the Chair of the Board of the Latvian Pharmacists’ Association, Agnese Ritene, and the Director of the Bachelor’s and Master’s Programmes in Pharmacy at the University of Latvia (LU), Zane Dzirkale, also met for a joint public discussion to evaluate the implementation process of the reforms proposed by the Ministry of Health and to highlight the most important issues for patients.

“I would like to thank the pharmacists who have coped well with this situation overall. Few people are expressing appreciation to them at the moment, so I would particularly like to commend the work of my colleagues. Of course, every day we face many technical uncertainties, nuances in legislation that are not covered by the law, as well as dissatisfaction and uncertainty among the public when faced with new developments,” says LFB President Ķikute.

She also emphasizes the particularly strict regulations in the industry, which impose severe penalties on pharmacists for any possible failure or incorrect performance of their duties.

“I still see this reform as an experiment. There are still no answers to many important questions, and at the same time, nuances are emerging that we had not anticipated and had no idea about. For example, on December 17, it was announced that repeat prescriptions would have to be digitized and taken away from patients. This was completely new to us. If we had six months to implement technical changes that we had been informed about in advance, then such a turn of events a week before the amendments came into force completely threw us off track. And, of course, keeping patients and pharmacists informed, especially during the holiday season, was challenging. Another major issue that has come to the fore in the last month is who covers the cost of delivering medicines from the wholesaler to the pharmacy. This issue needs to be resolved urgently so that patients are not left without medicines. At the same time, we are eagerly awaiting the ministry’s new pharmacy service plan. The knowledge and availability of pharmacists is an essential resource that can be used in healthcare for the benefit of patients,” said Ritene, chair of the Pharmacy Association’s board, describing the situation.

All participants in the talks agreed that the timely testing of significant innovations in the implementation of the reforms had been neglected.

For the planned process to move forward successfully, the Ministry of Health should have identified the mistakes in a timely manner and corrected them, or introduced the innovations gradually, one by one. At the same time, it has been found that the overall promised reduction in medicine prices for patients, if any, only minimal and fragmented for certain patient groups, whereas for large patient groups, medicines have become more expensive due to various circumstances, making it unlikely that the reform will have a long-term effect. As before, the majority of the price of medicines is made up of the manufacturer’s price and VAT. Although one of the stated goals of the reform is to balance prices with Lithuania and Estonia, this has only led to manufacturers raising their prices in Latvia to match those in neighboring countries.

LFAA Executive Director Kristīne Jučkoviča points out: “Until the VAT rate on medicines is reduced in Latvia and the list of reimbursable medicines and diagnoses is expanded, it will not be possible to equalize medicine prices with neighboring countries.

Furthermore, any uncertainty or inaccuracy caused by this reform will primarily affect patients, who have been largely overlooked in this process.

At this time, I urge pharmacy customers to be understanding, as the work and responsibility towards patients that the state has placed on pharmacists in the first weeks of the reform is complex and resource-intensive.”

The experts in the discussion focused in particular on the role of pharmacists in the healthcare sector and the current geopolitical situation, as well as the prestige and relevance of the profession of pharmacist among future specialists, especially in view of the impact of the Ministry of Health’s reforms, which has brought about significant changes and uncertainty in the profession and areas of responsibility of pharmacists. Discussing these aspects, Zane Dzirkale, Director of the Bachelor’s and Master’s Programs in Pharmacy at the University of Latvia, repeatedly encouraged young people to choose the profession of pharmacist, pointing out that it is not only dynamic and exciting, but also a highly responsible and socially valued specialty. She encouraged patients to find their own trusted pharmacist and to take advantage of their unique knowledge and pharmaceutical care, participating in the maintenance of their own health and treatment process.