France’s disappearing pharmacies

“Funny … I thought there was a pharmacy ( geo allo ) on that corner”. So what’s happening to those green crosses? That pharmacy on the corner – like all the other offices across France, to use the professional term – put up the shutters for good last year rather than being sold on as a going concern which has been the tradition. That just shows how fast economic transformation can occur.

When I last spoke to a pharmacist some ten years ago, who now retired – she told me that her calling offered “a good living, security, a certain prestige and a lot of personal pleasure”. That conclusion was modified somewhat when I talked to some other expert at her pharmacy at Nice. She recently became, by the way, the best-known pharmacist in France.

A profession in crisis

Although by no means a pessimist, she confesses that things have changed and that her occupation is in crisis. For me, that’s no great surprise since, like many immigrants, I’ve been puzzled by the number of shops you pass showing that distinctive green cross. When I enquired a decade ago France had one pharmacy for every 1600 inhabitants – compared with one for every 5000 Brits and one for every 15,000 Danes.

“That must be very hard on the elderly,” she remarked “who’ve got a long trip to pick up their medicines.” But why does France have so many pharmacies? “Several reasons, I’d say. The French have always cared a lot about their health and they like medical services to be close at hand and, of course, over the past 60 years the Sécu has subsidised these preferences. Until recently to be a chemist did offer the gratifications.

So what’s going on?

Essentially there’s a financial crisis. As Jean- Marie Soyer, president of the pharmacists’ suggestion in the Alpes- Maritimes, told Nice-Matin recently, “Of 466 officines in the department some two-thirds are facing financial difficulties. Their prices are fixed by the government and they’ve moved up very slowly. It’s generally agreed that since the Nineties our margins have fallen by about 50%.

And then in their effort to shrink the deficit of the Sécu the government has been putting pressure on doctors to prescribe less and at the same time on some products the amount of repayment has been cut or even eliminated and so demand goes down. On top of that you’ve got a fall in the number of GPs. The ideal site for an officine is close by a cabinet de généraliste. If a doctor retires and isn’t replaced the local pharmacy sees a drop in turnover.

New forms of competition

And, of course, there are now new ways of competing to be faced. “That’s right. For example, we can’t rely on para- pharmacy to increase our turnover. That’s been largely taken over by the supermarkets who can discount seriously. Then there’s the internet. It’s a menace and mainly for people’s health. It’s just not on to buy medicines online with no proper advice and often no quality control.”

And what if the supermarkets get into the core business, as they hope to do? It is for sure, not a good development. Whatever they say now, they’d end up giving pharmaceuticals like groceries. And there is a difference.”

Do we see any reason for being optimistic? Of course we do. At the beginning there was a lot of consumer doubt and the pharmaceutical companies still try to pressure doctors into prescribing famous products but the amount of generics within the sale of prescription medicines is now over and over and it keeps rising.

At a different level many pharmacists – once fiercely independent – have seen the advantage of collaboration and have come together in what we call groupements de conseils which offer benefits in areas like wholesale buying and marketing. It doesn’t always work out even though a lot of them have tried it out.
One criticism I’ve heard of pharmacies concerns a big difference in the pricing of over-the-counter products. A survey found that a box of sweets for the shore throat could cost anything between €3.0 and €6. “Maybe in the country where there’s less competition you can get away with a bit of gouging. In town you have to charge what the market will bear. There’s a trade website that specifies what’s currently being charged for many items and that has to be your guide.”

The urgent and immediate service of every sick man in France by a Pharmacy de garde wich stays open during the day and the night too is what makes pharmacists play an essential role in the life of French people.

The human side makes it rewarding

It’s always interesting to ask any professional or dentists ( dentiste urgence ) if they’d like their children to have the same career as them. How did they respond to this? They’ve answered that for me. No way would they like to be chemists. They’ve seen how hard the work is , they usually are at the store more than at home–and they don’t fancy all that paperwork we face these days. Certainly, you have to put in a lot of time to make a living and that’s after 10-year exercise. But there’s another side to it: as a neighborhood pharmacist plays an important part in peoples’ lives as a source of advice and comfort that no website can rival. It’s the human side of the job that makes it rewarding. Nobody is thinking of early retirement.”

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