Chapter 3: Customer satisfaction over patient security? Value hierarchization in pharmaceutical retail
Pharmaceutical retail is an area with a generally high degree of state control in the form of regulated pricing, regulation of the marketplace via rules regarding opening hours, number and/or location of pharmacies, ownership arrangements and demands on professional qualifications. For example, within the EU alone, there are several different organizational models when it comes to pharmaceutical retailing, based on values such as safety, health, professionalism, availability and efficiency. In 2009, after 38 years of public monopoly on pharmaceutical retail, the Swedish government decided to reorganize the market. Almost overnight, both the market for prescription drugs and over the counter (OTC) medicines were exposed to competition. Although the realization of the demonopolization could be perceived by the general public as a hasty political decision, I demonstrate in this chapter how the regulation of pharmaceuticals has been debated in the political sphere and has long been a hard issue to solve in Sweden. The political disagreement on the topic has been based in part on different views of what values should take priority when it comes to pharmaceutical retail. As early as in the 16th century, the pharmacy market was subject to regulations and control. All pharmacies in Sweden at that time were privately owned, but in order to operate a pharmacy one had to be granted a special privilege by the king, requiring that certain conditions and skills be met. Centuries later, around 1920, an extensive reform was undertaken, leading to the economic collectivization of the pharmacy industry.
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