The cross : The number of pharmacies has been decreasing for ten years. Between January 2021 and January 2022 alone, 215 pharmacies lowered the curtain. How to explain it?
Pierre Beguerie: Nearly half of these closures are actually due to consolidation. Small towns or villages sometimes have two pharmacies, sometimes they are even in the same street. They therefore decided to group together to meet the quota – it takes 2,500 inhabitants for a pharmacy to be able to set up shop – and thus offer a service more suited to the population.
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Overall, the territorial network remains fairly satisfactory in France, with one pharmacy for 3,200 inhabitants, compared to 5,000 or 10,000 in certain northern countries such as Denmark. And the average distance from the first pharmacy is 3.8 km.
In more than half of the cases, the pharmacy completely disappears from the map. What are the consequences for the populations concerned?
PG: These pharmacies that are closing for good are often found in towns where the population has decreased. The activity is no longer viable for the pharmacist who, of course, cannot sell his business. In 2018, the law on the creation and transfer of pharmacies began a reflection on “fragile” territories which, in addition to being far from pharmacies, have an elderly population or people with reduced mobility.
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These people need to be able to access a pharmacy without traveling miles on potentially dangerous roads. A decree should soon come out, in order to allow the Regional Health Agencies (ARS) to identify these territories in difficulty and, if necessary, to transfer surplus pharmacies there. But the territorial network is something delicate. It is enough for a pharmacy to move to a very commercial place for those around it to lose their attractiveness. It is a fragile balance that must not be destabilized.
Is the future in large groups of pharmacies?
PG: Fewer and fewer pharmacists work alone. Nearly three quarters of pharmacies are grouped together, but beware: in France, all pharmacies are independent, it’s written into the public health code. Their capital can only be held by professionals and as such, cannot belong to large economic groups or pension funds whose only objective would be the profits of their shareholders.
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What exists today are pharmacists who unite in the form of associations or economic interest groups in order to pool purchasing, operating or marketing costs. Nevertheless, each holder continues to control the hiring of his staff, his loans…
What lessons does the profession draw from these two years of pandemic?
PG: The entire pharmaceutical chain has been mobilized to support the population and healthcare professionals. We ensured the distribution of masks, vaccination, antigenic tests, the manufacture of hydroalcoholic gel. The conditions imposed by the crisis have been real accelerators for the evolution of the missions that we carry out.
For example, we were given the possibility of renewing certain prescriptions in agreement with the doctor, in order to avoid patients having to consult. In addition to helping the population, these tasks contribute to making the job more attractive. Moreover, the young people, who had turned away from the pharmacy, are beginning to come back to it.
What missions could the profession carry out in the future?
PG: In certain territories, where the medical presence is reduced, the pharmacy is sometimes the last small Gallic village where one has access to a health service. We already do rapid diagnostic orientation tests (Trod) for angina, with the possibility of prescribing antibiotics if the infection is bacterial.
This principle could be extended to other non-serious illnesses, such as cystitis, for which we could ensure screening and monitoring according to a protocol validated by the authorities.
More broadly, the pharmacist has a key role to play in terms of prevention. By focusing on therapeutic patient education, we would prevent certain diseases from becoming acute or chronic, while freeing doctors from time-consuming tasks.