A simmering dispute in the Czech pharmaceutical sector is heading to the Senate this week, as thousands of pharmacists rally behind a petition highlighting significant inequalities in medication distribution. Small independent pharmacies claim they’re struggling to obtain medications that larger chains receive with ease—and when they do, it’s often under far worse conditions. “We look like thieves to our patients,” say pharmacists frustrated by the current distribution system and unable to compete with franchises that often waive medication copayments.
The petition, signed by twelve thousand people including representatives from a hundred pharmacies, calls for equal access to medications across all pharmacies without preferential treatment for large chains. Behind this movement are pharmacist couple the Nedopils, who view their profession as more than just “generic drug selling in single-colored design pharmacies” without personal care. They argue that in rural areas especially, pharmacists remain community authorities who handle intimate patient concerns and maintain relationships with local doctors.
The core issue revolves around medication pricing and availability. When independent pharmacies manage to source medications like insulin, insurance reimbursements are often lower than purchase prices, forcing patients to pay additional fees. Meanwhile, patients report no such copayments at chain pharmacies. Some small pharmacies have resorted to covering these copayments themselves to retain customers. Distributors have reportedly canceled Saturday deliveries in some areas, demanded cash payments upfront, or charged distribution fees—despite having a legal obligation to supply insurance-covered medications.
The Senate’s petition committee already deemed the petition partially justified in May. Senator Pavel Kárník (STAN) acknowledges that “despite recent legislative changes, discrimination against small private pharmacies still occurs,” questioning whether there should be mechanisms for state-initiated controls rather than relying solely on pharmacy complaints. However, he considers some petition demands—such as complete legislative overhauls and changes to maximum drug pricing—to be beyond the petition’s original scope.
Major pharmacy chains and distributors reject the petition’s claims. Phoenix, a pharmaceutical wholesaler that owns the Benu pharmacy chain, “categorically denies” giving preferential treatment to its own pharmacies, stating that delivery frequency rules apply equally to all business partners based on economic indicators. Similarly, Dr. Max spokesperson Michal Petrov insists their chain receives no preferential treatment, suggesting their advantage comes from being able to substitute stock shortages with their own branded products.
The Ministry of Health notes that legislation effective January 1, 2024, prohibits distributors from favoring any pharmacy during ordering processes, with enforcement falling under the State Institute for Drug Control. However, petitioners argue the current environment without clear copayment standards creates a “bottomless money pit” in healthcare, with Lucie Nedopilová pointing out that “when pharmacy operators build their business on advertising medication dispensing without copayments, it causes enormous losses for the health insurance system, as patients accumulate prescription medications they don’t use, which eventually expire.”
