Pharmacies in Russia, Ukraine and the UK have common aim - to help people to improve their health and achieve higher quality of life but at the same time there are many factors that contribute to differences in work of those pharmacies.

Main data and standards

Ukraine with a population of 50 million and territory of France is the second largest country on the territory of the former Soviet Union. Number of the pharmacies in Ukraine is 11460 and the number of pharmacists involved in retail and hospital pharmacies is a little more than 40000. So, roughly, there are 3-4 pharmacists working in each particular pharmacy (data on the 1 Jan. 2002).
Russia is the biggest country of the post Soviet area with a population 150 million and territory equal to 70 territories of the Great Britain. Number of pharmacies there is near to 40000 and pharmacists involved are a little more than 120000.

Private pharmaceutical sector is still developing in both countries, so, there are mainly state pharmacies and pharmacies that are joint-stock companies operate on the market. For instance, dynamic of the pharmacies ownership in Ukraine looks like the following.

In Russia share of the state and municipal pharmacies is 40%.

Historically pharmacies in Russia and Ukraine were created in accordance to the sole standards during Soviet period. There were precise standards regulating size and number of the pharmacy premises, number of the pharmacists, etc.
Pharmacies were divided into the categories in accordance to their size and resources. With higher category grows significance of the pharmacy in its region, duties, and responsibilities.
For instance, an average 1-st category retail pharmacy (ready-made medicines) had minimum total area 201sq.m. that included retail area and premise for service to customers (75 sq.m.), administrative rooms, incl. manager's room (24sq.m.), material rooms, store rooms, unpacking room, staff room, sanitary rooms. Pharmacies which prepare extemporaneous medicines, eye drops, solutions for hospitals, soaks etc. usually have more premises and certainly preparation room and laboratory on the top of the above. Majority of today's pharmacies comply with the above standards.
Many pharmacies have special divisions named pharmacy points. They could be opened in the premises of the medical institutions only. Minimum size of such a point is 18 sq.m. Those points usually have one pharmacist and should sell OTC medicines, Para pharmaceutics, hygienic and baby products only, but often dispense prescription medicines. Pharmacy points could not be considered as a pharmacy, but as a division of the pharmacy they belong to. Practice of the opening such a points helps many pharmacies to spread their activity, cover bigger territory and earn more.
Minimum number of the pharmacists working in the pharmacy of the ready-made medicines is 2, but in the pharmacy making extemporaneous medicines 3. The other pharmacy workers are pharmaceutical technicians - people with vocational pharmaceutical education (length of the educational course is 3 years).

Market and regulations

With the collapse of the Soviet Union each country started to build own pharmaceutical market. Russia, which was main raw materials supplier, remained almost without final pharmaceutical products manufacturers. Ukraine, on the contrary, remained with big production capacity but almost without raw materials. Problem with raw materials was solved much easier than building new pharmaceutical plants in Russia. Due to all this there were different priorities in each country regarding support of the national manufacturers. Important role during the first period of the newly established pharmaceutical markets was played by imported medicines. So, huge number of the pharmaceutical distributors set up their business during that time.
Development of the market place and the corresponding legislation makes corrections and distributors enlarge and amalgamate their business, but their number is still big since there no national distributor able to cover all territory of the country (either Ukraine or Russia).

Ministry of Health plays regulating and licensing role for the pharmacy. So, according to the law, profit margin of the wholesaler + retailer should not exceed 50 % from the manufacturer's price. Wholesaler's margin in Ukraine varies 15-20%, retail margin 30-35%. An average retail margin in Russia is 27%.

Both local legislations (in Russia and Ukraine) permit sales of the medicines through the pharmacies only, so there no possibility to buy even OTC medicaments in the shops or supermarkets like in the UK. Also, there no limitations on the number of the pharmacies to be owned and that is why pharmacy chains commenced in both countries.

Centralized distribution background of the former soviet pharmacies was predisposition factor for creation of the pharmacy chains in both countries.
Now there are approximately 100 pharmacy chains works in different regions of Russia and their share on the market is 25-30%. Monthly sales of the pharmacy chain in Russia is in range of 400 thousand to 4 million USD.
Share of the big and medium chains in structure of the pharmacy in Ukraine is 50, 6 %, while small chains share is 32, 6%.
Legally medicines divided on OTC and prescription only. Shares of the OTC medicines is 70% and POM - 30%.In addition to medicines pharmacies sale wide range of products that include cosmetics, Para pharmaceutics, baby products, hygienic products, herbs, etc.

Distribution of the medicines nomenclature in Russia and Ukraine (beginning 2002) is illustrated in the table, which shows similarity of the markets.

Needs and services

There is no reimbursement system similar to UK ones implemented yet and people usually pay full price for the medicines. But due to state programs some patients could receive medicines for half price or free-of-charge from the pharmacies. For instance, in Ukraine there are several programs supported by the state budget:

• Immunoprophylaxis
• Oncology treatment
• Diabetes
• Transplantation
• Control of the individual doses of the radiation
• Prophylaxis and treatment of AIDS
• Development of blood donation and its components.

Expenditure for healthcare needs from state budget in Ukraine is 3, 1% (in comparison with an average such a spending in Europe 6, 2%). Only 10% from the above is budgeted for medicines.
Demand for the pharmaceutical products is mainly involved with extreme necessity of the patients to spend money for the purchase of the medicines. And since an average income growth is very slow major part of the population cannot afford essential medicines.

With collapse of the centralized system of the medicines supply established in the former Soviet Union, Russian and Ukrainian pharmacies faced conditions of the emergent economy with new requirements and new skills to be developed in shortest terms. So, usual once-a-month stable centralized deliveries of the accurately prepared orders were substituted to many orders from selection of the distributors, preparation of the orders of the newly registered foreign medicines and forecasts of the demand for them, planning of the promotion campaigns etc. Some pharmacies still keep practice of the once a month orders, but majority have weekly or daily deliveries.

Computer systems installed in the pharmacies are mainly used for stock control, orders preparation and communications with suppliers and most advanced have access to the National Register of the medicines, adverse reactions, clinical data etc. There is no PMR's database.

Pharmacists allowed substituting branded products recommended by doctors to generics and main reason for this is price.
Home delivery service was always restricted by personal presence of the pharmacist, but now, according to the latest amendments to the legislation in Russia home delivery of the medicines is prohibited.

New tendency on those markets is pharmacy working 24 hours a day 7 days a week (a modern substitution of the former pharmacy-in-duty).
Usual working hours of the average pharmacy are from 7-8 a.m. to 8-10 p.m. Staff ordinary works in shifts. This helps to deliver service to those whose working hours are long.

Education

Russian and Ukrainian pharmacists study pharmacy for 5 years and then undergo one year training. There are 9 pharmaceutical schools in different universities and one Pharmaceutical Academy in Ukraine. In Russia pharmaceutical schools are usually opened as departments or faculties in number of Universities and Medical Institutes (Academies).
Students from many countries study in those schools: form CIS, African, South American, Asian, and Arabian countries.
Educational course covers all similar subjects to UK's course but additionally, has courses of Latin (because of requirements to prescriptions, herbal products and all chemicals within the pharmacy to be written on Latin and since it is widely used in practice), Pharmacognosy, Toxicology, Management and Marketing.
Post-diploma education is compulsory and pharmacists must pass one month length courses in corresponding Universities and computerized tests every five years. On the basis of the tests results new qualification could be awarded.
There are 7 qualifications exist: 6-th awarded after successful graduation training (which is alike UK's pre-registration training), other qualifications could be achieved by passing qualifying tests. Highest qualification is named "the highest" and usually awarded to the highly talented pharmacists with significant experience.

Role of the pharmacists is widely recognized as important and profession is highly respected. In spite to lack of proper legislation and regulations of the practice within new market conditions pharmacies remain the first call ports to many customers and pharmacists do their best in delivery good service despite to low salary and long working hours.