Liberalization and integration of drug distribution in the EU 28 and Norway.

The pharmaceutical distribution system in Europe is undergoing a long-term change. Wholesale companies join together to form both horizontally and vertically integrated structures. Pharmacies, formerly owned almost exclusively by pharmacists, are becoming part of the chain thanks to the liberalization of operating conditions. Chains are expanding successfully due to economies of scale and purchasing power for negotiation with suppliers. Independent pharmacies are becoming part of virtual chains to better compete with chains. An assortment previously reserved to pharmacies is also marketed in food stores or gas pumps due to legislative changes. E-pharmacies and e-shops compete in the area of over-the-counter pharmaceuticals and the complementary range of pharmacies. The paper describes systems of pharmaceutical distribution and their specifics in individual EU countries and Norway. In eight EU countries, the legislative framework does not allow the formation of pharmacy chains. More than 50% of public pharmacies are integrated into chains in six member states. A question remains concerning the influence of these different approaches to market regulation and thus different functioning of the market on the availability of pharmaceuticals for customers and also on the total costs of the pharmaceutical distribution system. Key words: pharmaceutical distribution • community pharmacy • EU28 • liberalization • integration.