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» RURAL PHARMACY
Lindy Swain was the 2014 PSA Pharmacist of the
Year. Her trip to Finland was funded by the her Award
Lessons from Finnish
BY LINDY SWAIN
Finland is a beautiful country of forests, timber houses, castles, lakes, lakes
and...more lakes. With a population of only 5.5 million, Finland is the most
sparsely populated country in the European Union. From December to
April the lakes are frozen and the ground is covered with snow.
Like Australia, Finland has large rural
areas that are sparsely populated.
Finland only has 817 pharmacies,
yet, even in some of the most
remote areas of Finland there are
To operate a community pharmacy in
Finland a pharmacist requires a pharmacy
licence, granted by the Finnish Medicines
Agency (Fimea). The licence is granted
for a specific location and catchment
area. A pharmacist may only hold one
pharmacy licence and this licence
remains with an individual until the
pharmacist chooses to give it up or until
she or he turns 68 years old. Fimea may
grant permission for the pharmacist to
operate a subsidiary pharmacy or service
points within the catchment area if
there are no other pharmacies and if it
will improve client access to medicines.
A pharmacy licence cannot be sold
To be granted a licence, pharmacists
must apply and prove through
a competitive process that they
are professionally and financially
responsible, and ‘best qualified’.
In Finland ‘best qualified’ means a
four-year Masters degree in pharmacy,
a passion for excellence in pharmacy
practice and aptitude for business.
This aptitude is often tested by
providing a licence to a smaller
pharmacy for the less experienced.
New pharmacy owners do not have
the luxury of choosing where they live;
they have to go where there is a licence
available. The competition for small and
remote pharmacy licences is less than
for urban pharmacies and thus remote
pharmacy is often the entry point into
ownership for young pharmacists.
Pharmacies in Finland pay a licence fee
to the state as a percentage of turnover.
Smaller pharmacies are exempt from
this fee. Unlike Australia, there is no
high pharmacy purchase price, allowing
Finnish pharmacists to achieve a good
income, even in very remote areas.
Pharmacies in Finland are very clinically
orientated with about 80% of their sales
being from prescription medicines.
They stock only clinically orientated,
evidence-based OTC products.
They employ many pharmacists, a few
technicians and few, if any, shop assistants.
For example, an Australian pharmacy with
one or two pharmacists might, in Finland,
have five or six. Many of the employed
pharmacists have a three year Bachelor
degree, making them more affordable
than the more specialised pharmacists
with a four year Masters degree.
Pharmacies in Finland have been
streamlining their working methods
through automation. They have doubled
their use of dispensing robots over the
past five years.
Electronic prescriptions are a part
of everyday healthcare in Finland;
92% of prescriptions were electronic
by the end of 2014 and the Finnish
Parliament has decided that all
prescriptions must be in electronic
format from the beginning of 2017.
The prescriber writes the prescription
electronically and stores it in a
nationwide database, the Prescription
Centre. When a client presents at the
pharmacy, the pharmacist swipes
his or her provider card to access the
Prescription Centre and the client’s card/
number to access her or his healthcare
records. The prescriber can see when
a prescription has been dispensed.
Clients can access to their health records
and request a repeat prescription
through the Prescription Centre.
Clients entering a larger Finnish
pharmacy typically select the service
they require and take a numbered
ticket (as with Medicare in Australia).
They will sit with a pharmacist in a
semi-private booth, and the pharmacist
answers queries and accesses electronic
prescriptions. The dispensing robot will
pick and label the medication whilst
the pharmacist counsels the patient.
The medication arrives via a chute to the
pharmacist’s desk and is then checked
and handed out by the pharmacist.
Currently there is no remuneration
mechanism for medication reviews,
chronic disease programs or minor
ailment services. However the
Association of Finnish Pharmacists
has awarded a large grant to a staff
pharmacist to carry out a study on
the effectiveness of comprehensive
medication reviews. They are very
interested in the Australian Home
Medicines Review model.
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