Will pharmacies soon return to villages that lack them? Since July, a decree has allowed for more flexible conditions for the installation of pharmacies in villages with fewer than 2,500 inhabitants. Supplies have been awaited for more than six years by people living in medical and pharmaceutical deserts.
In fact, the decree makes applicable an order from the Ministry of Health which was adopted on 3 January 2018. Surprisingly, a text has never entered into force since then. To the point that senators presented a bill in April that included the general lines of the 2018 decree to put pressure on the government. But this time it was the right one: the system of “fragile territories” is finally in force.
No more than one pharmacy for every 4,500 inhabitants of a city
What does it mean? It allows pharmacists to open a pharmacy in a municipality with fewer than 2,500 inhabitants.
The opening of a pharmacy is highly regulated in France. A qualified pharmacist must obtain the approval of the Regional Health Agency (ARS), which will give him the mandatory operating license and its exact location. With very strict geodemographic criteria: prohibition, until now, of opening a new pharmacy in a municipality of less than 2,500 inhabitants (unless it is absorbed in the event of the closure of an existing pharmacy) or even no more than one pharmacy for every 4,500 inhabitants of a town.
If the latter provision can be understood as a way of avoiding concentrations of pharmacies in large cities to the detriment of less populated areas, the first, on the other hand, which limited the establishment in small towns, was less understandable, especially in the current logic of pharmaceutical desertification. The pharmacists’ unions wanted to maintain these rules that protected them against competition that could endanger their profitability.
1,000 fewer pharmacies in five years
But now the ARS can authorize new pharmacies in territories that were previously excluded. However, these so-called “fragile” territories must meet several conditions to be on the ARS list.
The opening may take place in a municipality with fewer than 2,500 inhabitants if the latter is part of a group of contiguous municipalities without a pharmacy. If these municipalities together have at least 2,500 inhabitants and if at least one of these municipalities has 2,000 inhabitants. The ordinance also opens up the possibility of creating a pharmacy in these sparsely populated areas without these population thresholds, provided that it is “close to a shopping centre, a health centre or a health centre”.
These relaxations should, the government hopes, allow certain medical deserts to be revived. Since the 2010s, we have seen a significant drop in the number of pharmacies in France. In the last five years alone, while pharmacies have been very busy during the Covid pandemic, their number has decreased by 5%, i.e. around a thousand fewer pharmacies.
The Ministry of Health estimates that their number has fallen below 20,000 in recent months, or 4,000 fewer in 15 years. Frédéric Valletoux, the outgoing minister in charge of Health, estimated last April in the Senate that “almost ten pharmacies [étaient] on sale for one euro but I can’t find it[ai]”There are no buyers, especially in rural areas.”
Relaxing the conditions for opening up is a first step towards the “pharmaceutical rearmament” of fragile territories, but it will certainly also be necessary to encourage pharmacists to settle in less attractive rural communities.
Source: BFM TV
