Primary health care pharmacists and vision for community pharmacy and pharmacists in Chile



Pharmacies, Primary Health Care, Delivery of Health Care, Integrated, Ambulatory Care, Community Health Services, Pharmacists, Community Pharmacy Services, Professional Practice, Chile


The Chilean healthcare system is composed of public and private sectors, with most of the higher-income population being covered privately. Primary healthcare in the public system is provided in more than 2,500 public primary care centers of different sizes with assigned populations within territories. Private insurance companies have their own healthcare networks or buy services from individual health providers. Patients from the public system receive most medications free of charge in primary care pharmacies embedded in each care center. Private patients must purchase their medicines from community pharmacies. Some government policies subsidize part of the cost of medications, but original medicines remain as the most expensive of Latin America. Three chain pharmacies have more than 90% of the market share, and these pharmacies have negative public perception because of price collusion court sentences. A non-profit, municipal pharmacy model was developed but has limited implementation. Most privately owned independent and chain community pharmacies do not provide pharmaceutical services as there is no remuneration or cover by insurers. The limited number of publicly owned Municipal pharmacies could implement pharmaceutical services in community settings as they are non-profit establishments and have full-time pharmacists but are not resourced for these services. A limited number of pharmaceutical services are almost exclusively provided in public primary care, including medication reviews, pharmaceutical education, home visits and pharmacovigilance services, but several barriers to their implementation remain. A risk-based multimorbidity care model was implemented in 2020 for public primary care with additional employment of part-time pharmacists to provide services. We believe that this model will help pharmacists to optimize their time by prioritizing the much-needed clinical tasks. We propose within this multimorbidity care model that the more time-consuming services are provided to higher risk patients. Pharmacy prescribing i.e. amending or approving changes in medications in primary care for chronic conditions could also be useful for the health system, but pharmacists would require additional training. The landscape for pharmaceutical services for primary care in Chile is promising, but the integration with community pharmacies will not be possible until they are funded by public and private insurance, and the public perception of these establishments is improved.


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Instituto Nacional de Estadística. Síntesis de Resultados CENSO 2017. Available at: (accessed Aug 7, 2020).

The World Bank. Chile. Available at: (accessed Aug 7, 2020).

OECD. Chile. Available at: (accessed Aug 7, 2020).

Cid C, Uthoff A.[The pending health reform in Chile: reflections on a proposal to transform the system]. Rev Panam Salud Publica. 2017;41:e170.

Chilean Health Superintendency. Private Insured Patients report 1990-2017. Available from: (accessed Aug 7, 2020).

Nazzal C, Frenz P, Alonso FT, Lanas F. Effective universal health coverage and improved 1-year survival after acute myocardial infarction: the Chilean experience. Health Policy Plan. 2016;31(6):700-705.

MINSAL. Official GES decree 2019. [Internet] [cited 2020 Aug 7]. Available at: (accessed Aug 7, 2020).

MINSAL. Ley 20.850 “Ricarte Soto”. Available at: (accessed Aug 7, 2020).

PAHO. Chilean Healthcare system. Available at: (accessed Aug 7, 2020).

MINSAL. Chilean Government. Available at: (accessed Aug 7, 2020).

WHO. Sustainable Development Goals (SDGs). Available at: (accessed Aug 7, 2020).

MINSAL. Department of health statistics and information (DEIS). Available at: (accessed Aug 7, 2020).

PAHO/WHO. Renewing primary health care in the Americas: A position paper of the Pan American Health Organization/World Health Organization. Available at: (accessed Aug 7, 2020).

MINSAL. Implementation guidelines of the family medicine model. Available at: (accessed Aug 7, 2020).

National Chilean Congress. Healthcare system and the municipal primary care model. Available at: (accessed Aug 7, 2020).

IQVIA. Comparative analysis: Latin American region pricing. Available at: (accessed Aug 7, 2020).

LyD. Precios de medicamentos: la importancia de avanzar. Available at: (accessed Aug 7, 2020).

Prescription, dispensing and patient information in primary care establishments. Available at:,%20Dispensacion%20e%20Informacion%20al%20Paciente%20en%20establecimientos%20APS.pdf (accessed Aug 7, 2020).

Technical guidelines for the Pharmacy Funds program 2019. Available at: (accessed Aug 7, 2020).

FONASA. FONASA extends medication Price reduction benefits nationwide. Available at: (accessed Aug 7, 2020).

Press Release 11/10/2019. La Tercera. Available from: (accessed Aug 7, 2020).

MINSAL. By-Law 466 about Pharmacies, drugstores and pharmaceutical deposits. Available at: (accessed Aug 7, 2020).

Acuna P. Pharmacy Practice in Chile. In: Fathelrahman AI, Ibrahim MI, Wertheimer AI, eds. Pharmacy Practice in Developing Countries. London: Elsevier; 2016. ISBN: 978-0-12-801714-2.

Llorente & Cuenca. El nuevo consumidor latinoamericano: Cuestión de confianza. Available at: (accessed Aug 7, 2020).

Chilean Supreme Court. Rol N° 2578-2012. Available at: (accessed Aug 7, 2020).

Library of the Chilean National Congress. Adjustments to the law 20.724 and generic policy in Chile. Available from: (accessed Aug 7, 2020).

Martínez-Mardones F, Plaza-Plaza C, Palma L.Development and implementation of a medication review with follow-up program in polymedicated older adult patients in a primary care center. 1º Simpodader Internacional. June 24 –26, 2016, Granada, Spain.

Chilean Ministry of Health, 2017 Guidelines for the cardiovascular care program. Available at: (accessed Aug 7, 2020).

Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, Kos M. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018;40(5):1199-1208.

Garcia-Cardenas V, Perez-Escamilla B, Fernandez-Llimos F, Benrimoj SI. The complexity of implementation factors in professional pharmacy services. Res Social Adm Pharm. 2018;14(5):498-500.

MINSAL. [Strategy for patient-centered seamless care to promote, prevent and manage chronic conditions in multimorbidity]. Santiago: MINSAL; 2020.

MINSAL. Descripcion de aspectos técnicos y conocimientos para la certificación de especialidades del área de química y farmacia. Available from: (accessed Aug 7, 2020).

Martínez-Mardones F, Fernandez-Llimos F, Benrimoj SI, Ahumada-Canale A, Plaza-Plaza JC, S Tonin F, Garcia-Cardenas V. Systematic Review and Meta-Analysis of Medication Reviews Conducted by Pharmacists on Cardiovascular Diseases Risk Factors in Ambulatory Care. J Am Heart Assoc. 2019;8(22):e013627.

Cardwell K, Smith SM, Clyne B, McCullagh L, Wallace E, Kirke C, Fahey T, Moriarty F; General Practice Pharmacist (GPP) Study Group. Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study. BMJ Open. 2020;10(6):e035087.

Smith AJ, Scahill SL, Harrison J, Carroll T, Medlicott NJ. Service provision in the wake of a new funding model for community pharmacy. BMC Health Serv Res. 2018;18(1):307.

Brown TJ, Todd A, O'Malley C, Moore HJ, Husband AK, Bambra C, Kasim A, Sniehotta FF, Steed L, Smith S, Nield L, Summerbell CD. Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation. BMJ Open. 2016;6(2):e009828.

Melton BL, Lai Z. Review of community pharmacy services: what is being performed, and where are the opportunities for improvement?. Integr Pharm Res Pract. 2017;6:79-89.

Dineen-Griffin S, Benrimoj SI, Rogers K, Williams KA, Garcia-Cardenas V. Cluster randomised controlled trial evaluating the clinical and humanistic impact of a pharmacist-led minor ailment service. BMJ Qual Saf. 2020. [Ahead of Print].




How to Cite

Martinez-Mardones F, Ahumada-Canale A, Gonzalez-Machuca L, Plaza-Plaza JC. Primary health care pharmacists and vision for community pharmacy and pharmacists in Chile . Pharm Pract (Granada) [Internet]. 2020 Aug. 28 [cited 2021 Oct. 20];18(3):2142. Available from: