Policy and vision for community pharmacies in Finland: A roadmap towards enhanced integration and reduced costs



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


Finland’s community pharmacy system provides an example of a privately-owned regulated system being proactively developed by the profession and its stakeholders. Community pharmacists have a legal duty to promote safe and rational medicine use in outpatient care. The development of professionally oriented practice has been nationally coordinated since the 1990s with the support of a national steering group consisting of professional bodies, authorities, pharmacy schools and continuing education centers. The primary focus has been in patient counseling services and public health programs. The services have extended towards prospective medication risk management applying evidence-based tools, databases and digitalization. Research has been essential in informing progress by indicating high-risk patients, medications, practices and processes needing improvement. Despite the commitment of the profession and pharmacy owners, large-scale implementation of services has been challenging because of lack of remuneration, the pharmacy income still consisting primarily of sale of prescription and nonprescription medicines. Policy documents by the Ministry of Social Affairs and Health have supported the extension of the community pharmacists’ role beyond traditional dispensing to promote rational pharmacotherapy. The current roadmap by the Ministry of Social Affairs and Health emphasizes ensuring adequate regional availability and accessibility of medicines, regardless of the future pharmacy system. It also emphasizes the importance of strong regulation on pharmacy business operations and sale of medicines to ensure medication safety. At the same time, the roadmap requires that the regulation must enable implementation of new patient-oriented services and procedures, and further promote digitalization in service provision. Competition and balance of funding should be enhanced, e.g., through price competition, but the risk of pharmaceutical market concentration should be managed. The regulation should also consider influence of the new social and health care system on drug delivery. Year 2021 will be crucial for making long-term political decisions on the future direction of tasks and finances of Finnish community pharmacies in this framework. Government-funded studies are underway to guide decision making. Ongoing Covid-19 crisis has demonstrated the readiness of Finnish community pharmacies to adapt fast to meet the changing societal needs.


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Statistics Finland. Findicator. https://findikaattori.fi/en (accessed Nov 22, 2020).

Keskimäki I, Tynkkynen L-K, Reissell E, Koivusalo M, Syrjä V, Vuorenkoski L, Rechel B, Karanikolos M. Finland: Health system review. Health Systems in Transition 21:2, 2019. https://apps.who.int/iris/bitstream/handle/10665/327538/HiT-21-2-2019-eng.pdf (accessed Nov 22, 2020).

Statistics Finland. Annual National Accounts 2019. http://www.stat.fi/til/vtp/2019/vtp_2019_2020-09-18_tau_001_en.html (accessed Nov 22, 2020).

OECD/European Observatory on Health Systems and Policies. Finland: Country Health Profile 2019. State of Health in the EU. https://ec.europa.eu/health/sites/health/files/state/docs/2019_chp_fi_english.pdf (accessed Nov 22, 2020).

Toivo T, Dimitrow M, Puustinen J, et al. Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness. BMC Geriatr. 2018;18(1):74. https://doi.org/10.1186/s12877-018-0737-z

Kallio S, Eskola T, Pohjanoksa-Mäntylä M, Airaksinen M. Medication Risk Management in Routine Dispensing in Community Pharmacies. Int J Environ Res Public Health. 2020;17(21):8186. https://doi.org/10.3390/ijerph17218186

Kallio S, Eskola T, Airaksinen M, Pohjanoksa-Mäntylä M. Identifying gaps in community pharmacists’ competence in medication risk management in routine dispensing. Innov Pharm. 2021;[in press].

Health and Social Services Reform in Finland. Official Website. https://soteuudistus.fi/en/frontpage (accessed Nov 22, 2020).

Rissanen P, Parhiala K, Hetemaa T, et al. Social and Healthcare Services in Finland 2018: Expert evaluation. Policy Brief 7/2020. National Institute for Welfare and Health. http://urn.fi/URN:ISBN:978-952-343-503-2 (accessed Nov 22, 2020).

Kanta. Official website. https://www.kanta.fi/en/ (accessed Nov 22,2020).

Apotti. Official website. https://www.apotti.fi/ (accessed Nov 22,2020).

Ministry of Social Affairs and Health. Rational Pharmacotherapy Action Plan – Final Report. Reports and Memorandums of the Ministry of Social Affairs and Health 19/2018. http://urn.fi/URN:ISBN:978-952-00-3930-1 (accessed Nov 22, 2020).

Ministry of Social Affairs and Health. Research for Evidence-Informed Decision-Making. Research Strategy for Rational Pharmacotherapy 2018–2022. Reports and Memorandums of the Ministry of Social Affairs and Health 25/2018. https://julkaisut.valtioneuvosto.fi/handle/10024/160940 (accessed Nov 22, 2020).

Ministry of Social Affairs and Health. Medicines Policy 2020: Towards efficient, safe, rational and cost-effective use of medicines. Publications of the Ministry of Social Affairs and Health 2/2011. Ministry of Social Affairs and Health, 2011. http://urn.fi/URN:ISBN:978-952-00-3165-7 (accessed Jan 15, 2021).

Schepel L. Strategies for medication safety: An organization-based approach focusing on high-alert medications and clinical pharmacy services in Helsinki University Hospital. Academic dissertation. University of Helsinki, Finland, 2018. http://urn.fi/URN:ISBN:978-951-51-4757-8 (accessed Nov 22, 2020).

Schepel L, Aronpuro K, Kvarnström K, et al. Strategies for improving medication safety in hospitals: Evolution of clinical pharmacy services. Res Social Adm Pharm. 2019;15(7):873-882. https://doi.org/10.1016/j.sapharm.2019.02.004

Finnish Medicines Agency Fimea. Rational use of medicines through information and guidance. Medicines information services: Current state and strategy for 2020. Fimea Develops, Assess and Informs Serial Publication 1/2012. http://urn.fi/URN:ISBN:978-952-5624-21-2 (accessed Nov 22, 2020).

Mononen N. From Paper to Cyber: Medicines Information as a strategic goal in Finland and the European Union. Academic dissertation. University of Helsinki, Finland, 2020. https://helda.helsinki.fi/handle/10138/313665 (accessed Nov 22, 2020).

Kumpusalo-Vauhkonen A, Järvensivu T, Mäntylä A. [A multidisciplinary approach to promoting sensible pharmacotherapy among aged persons: National assessment and recommendations]. Helsinki: Finnish Medicines Agency; 2016.

Kallio S, Kumpusalo-Vauhkonen A, Järvensivu T, Mäntylä A, Pohjanoksa-Mäntylä M, Airaksinen M. Towards interprofessional networking in medication management of the aged: current challenges and potential solutions in Finland. Scand J Prim Health Care. 2016;34(4):368-376. https://doi.org/10.1080/02813432.2016.1249055

Donabedian A. The quality of care. How can it be assessed?. JAMA. 1988;260(12):1743-1748. https://doi.org/10.1001/jama.260.12.1743

Ministry of Social Affairs and Health. Points of views on need for changes in medication and distribution system of medicines. Reports and Memorandums of the Ministry of Social Affairs and Health 5/2019. http://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/161340/STM_Rap_5_2019.pdf (accessed Nov 22, 2020).

National Institute for Welfare and Health. [Health expenditure and financing 2018]. https://thl.fi/fi/tilastot-ja-data/tilastot-aiheittain/sosiaali-ja-terveydenhuollon-resurssit/terveydenhuollon-menot-ja-rahoitus (accessed Nov 22, 2020).

Kurko T, Silvast A, Wahlroos H, Pietilä K, Airaksinen M. Is pharmaceutical policy evidence-informed? A case of the deregulation process of nicotine replacement therapy products in Finland. Health Policy. 2012;105(2-3):246-255. https://doi.org/10.1016/j.healthpol.2012.02.013

Kurko T. Deregulation of Nicotine Replacement Therapy Products in Finland: Reasons for pharmaceutical Policy Changes and Reflections on Smoking Cessation Practices. Academic dissertation. University of Helsinki, Finland, 2015. http://urn.fi/URN:ISBN:978-951-51-1223-1 (accessed Jan 10, 2021).

The Association of Finnish Pharmacies. Annual Review 2019. https://www.apteekkariliitto.fi/media/3-apteekkariliitto.fi/englanti/annual-reviews/annual_review_2019.pdf (accessed Jan 9, 2021).

Westerling A. Information Technology Development Needs in Community Pharmacies: A Strategic Approach. Academic dissertation. University of Helsinki, Finland, 2011. https://helda.helsinki.fi/handle/10138/28196 (accessed Jan 9, 2021).

Toivo TM, Mikkola JA, Laine K, Airaksinen M. Identifying high risk medications causing potential drug-drug interactions in outpatients: A prescription database study based on an online surveillance system. Res Social Adm Pharm. 2016;12(4):559-568. https://doi.org/10.1016/j.sapharm.2015.09.004

Toivo T, Airaksinen M, Dimitrow M, et al. Enhanced coordination of care to reduce medication risks in older home care clients in primary care: a randomized controlled trial. BMC Geriatr. 2019;19(1):332. https://doi.org/10.1186/s12877-019-1353-2

Toivo T. Prospective medication risk management in primary care: Enhancing coordination of care and community pharmacists' participation. Academic dissertation. University of Helsinki, Finland, 2020. https://helda.helsinki.fi/handle/10138/318724 (accessed Jan 9, 2021).

Mononen N, Airaksinen MSA, Hämeen-Anttila K, Helakorpi S, Pohjanoksa-Mäntylä M. Trends in the receipt of medicines information among Finnish adults in 1999-2014: a nationwide repeated cross-sectional survey. BMJ Open. 2019;9(6):e026377. https://doi.org/10.1136/bmjopen-2018-026377

Jokinen L, Puumalainen I, Airaksinen M. Influence of strategic planning on product marketing and health service orientation of community pharmacies-A national survey in Finland. Health Policy. 2019;123(5):462-467. https://doi.org/10.1016/j.healthpol.2019.02.006

Jokinen L, Puumalainen I, Airaksinen M. Factors associated with health service orientation and active product marketing orientation in Finnish community pharmacies: a nationwide study among private pharmacy owners. BMC Health Serv Res. 2020;20(1):667. https://doi.org/10.1186/s12913-020-05469-y

Sinnemäki J. Automated dose dispensing service for primary care patients and its impact on medication use, quality and safety. Academic dissertation. University of Helsinki, Finland, 2020. https://helda.helsinki.fi/handle/10138/319343 (accessed Jan 9, 2021).

Ministry of Social Affairs and Health. [Safe pharmacotherapy for the aged: obligations of municipalities]. Available at: https://stm.fi/artikkeli/-/asset_publisher/trygg-lakemedelsbehandling-for-aldre-kommunernas-forpliktelser (accessed Jan 10, 2021).

Ministry of Social Affairs and Health. [Good practices for automated dose dispensing of medicinal products]. Reports and Memorandums 1/2016. http://urn.fi/URN:ISBN:978-952-00-3692-8 (accessed Jan 10, 2021). In Finnish.

The Association of Finnish Pharmacies. Website. Available at: www.apteekkariliitto.fi (accessed Jan 10, 2021).

The Association of Finnish Pharmacies. [The New Pharmacy Program]. https://www.apteekkariliitto.fi/media/3-apteekkariliitto.fi/uusiapteekki/uusi_apteekki_julkaisu_sec.pdf (accessed Jan 10, 2021).

Jokinen L. Health services or medicines sales: strategic development of community pharmacies in a changing operating environment (Terveyserveyspalveluita vai myyntityötä: Apteekkien toiminnan strateginen kehittäminen muuttuvassa toimintaympäristössä). Academic dissertation. University of Helsinki, Finland, 2020. http://urn.fi/URN:ISBN:978-951-51-5837-6 (accessed Jan 10, 2021).

Fant A. [Online pharmacy operators' views on regulations, development and the future: differences between Finland and Sweden]. Master’s thesis. University of Helsinki, Finland, 2020.

Närhi U. Implementing the philosophy of pharmaceutical care into community pharmacy services - Experiences with asthma patients in Finland. Academic dissertation. University of Kuopio, Finland, 2001. https://erepo.uef.fi/bitstream/handle/123456789/9486/urn_isbn_951-781-152-7.pdf?sequence=1&isAllowed=y (accessed Jan 10, 2021).

Parkkamäki S. [The empowerment based support of type 2 diabetes self-management at the community pharmacy] . Academic dissertation. University of Helsinki, Finland, 2013. http://urn.fi/URN:ISBN:978-952-10-9057-8 (accessed Jan 10, 2021).

The Association of Finnish Pharmacies. [Pharmacy Programs]. https://www.apteekkariliitto.fi/apteekkitieto/ohjelmat.html (accessed Jan 10, 2021).

Puumalainen I. Development of instruments to measure quality of patient counselling. Academic dissertation. University of Kuopio, Finland, 2005. Available at: http://urn.fi/URN:ISBN:951-27-0053-0 (accessed Jan 10, 2021).

Kansanaho H. Implementation of the principles of patient counselling into practice in Finnish community pharmacies. Academic dissertation. University of Helsinki, Finland, 2006. https://helda.helsinki.fi/handle/10138/19144 (accessed Jan 10, 2021).

Leikola S. Development and application of a comprehensive medication review procedure to community-dwelling elderly. Academic dissertation. University of Helsinki, Finland, 2012. Available at: http://urn.fi/URN:ISBN:978-952-10-7698-5 (accessed Jan 10, 2021).

Bulajeva A, Labberton L, Leikola S, et al. Medication review practices in European countries. Res Social Adm Pharm. 2014;10(5):731-740. https://doi.org/10.1016/j.sapharm.2014.02.005

Dimitrow M. Development and validation of a drug-related problem risk assessment tool for use by practical nurses working with community-dwelling aged. Academic dissertation. University of Helsinki, Finland, 2016. Available at: http://urn.fi/URN:ISBN:978-951-51-2618-4 (accessed Jan 10, 2021).

Kiiski A, Airaksinen M, Mäntylä A, et al. An inventory of collaborative medication reviews for older adults - evolution of practices. BMC Geriatr. 2019;19(1):321. https://doi.org/10.1186/s12877-019-1317-6

Teinilä T, Grönroos V, Airaksinen M. A system approach to dispensing errors: a national study on perceptions of the Finnish community pharmacists. Pharm World Sci. 2008;30(6):823-833. https://doi.org/10.1007/s11096-008-9233-4

Teinilä T, Grönroos V, Airaksinen M. Survey of dispensing error practices in community pharmacies in Finland: a nationwide study. J Am Pharm Assoc (2003). 2009;49(5):604-610. https://doi.org/10.1331/japha.2009.08075

Teinilä T, Kaunisvesi K, Airaksinen M. Primary care physicians' perceptions of medication errors and error prevention in cooperation with community pharmacists. Res Social Adm Pharm. 2011;7(2):162-179. https://doi.org/10.1016/j.sapharm.2010.03.007

Härkänen M. Medication-related adverse outcomes and contributing factors among hospital patients - an analysis using hospital’s incident reports, the global trigger tool method, and observations with record reviews. Academic dissertation. The University of Eastern Finland, 2014. http://urn.fi/URN:ISBN:978-952-61-1636-5 (accessed Jan 10, 2021).

Holmström A-R. Learning from medication errors in healthcare – how to make medication error reporting systems work? Academic dissertation. University of Helsinki, Finland, 2017. http://urn.fi/URN:ISBN:978-951-51-3087-7 (accessed Jan 10, 2021).

Laatikainen O. Medication-related adverse events in health care. Academic dissertation. University of Oulu, Finland, 2020. http://urn.fi/urn:isbn:9789526225135 (accessed Jan 10, 2021).

Saastamoinen LK, Verho J. Register-based indicators for potentially inappropriate medication in high-cost patients with excessive polypharmacy. Pharmacoepidemiol Drug Saf. 2015;24(6):610-618. https://doi.org/10.1002/pds.3764

Ylä-Rautio H, Siissalo S, Leikola S. Drug-related problems and pharmacy interventions in non-prescription medication, with a focus on high-risk over-the-counter medications. Int J Clin Pharm. 2020;42(2):786-795. https://doi.org/10.1007/s11096-020-00984-8

Pharmacy Tax Act (Apteekkiverolaki) 770/2016. Available at: https://www.finlex.fi/fi/laki/ajantasa/2016/20160770 (accessed Jan 14, 2021).

Government Decree on the Tariff of Medicines (Valtioneuvoston asetus lääketaksasta) 713/2013. Available at: https://finlex.fi/fi/laki/ajantasa/2013/20130713 (accessed Jan 14, 2021).

Health Insurance Act 1224/2004. https://www.finlex.fi/en/laki/kaannokset/haku/?search%5Btype%5D=pika&search%5Bkieli%5D%5B%5D=en&search%5Bpika%5D=health+insurance+act&submit=Search (accessed January 21, 2020).

National Social Insurance Institution Kela. Reimbursements for medical expenses. https://www.kela.fi/web/en/medicine-expenses (accessed Jan 14, 2021).

National Social Insurance Institution Kela. [Pharmacies' health insurance instructions]. https://www.kela.fi/apteekki-ekstranet_apteekkien-sv-ohjeet (accessed Jan 14, 2021).

Ministry of Social Affairs and Health. Social welfare and health care system in Finland, responsibilities. https://stm.fi/en/social-and-health-services/responsible-agencies?p_p_id=56_INSTANCE_7SjjYVdYeJHp&p_p_lifecycle=0&p_p_state=normal&p_p_mode=view&p_p_col_id=column-2&p_p_col_count=2&_56_INSTANCE_7SjjYVdYeJHp_languageId=en_US (accessed Jan 14, 2021).




How to Cite

Airaksinen M, Toivo T, Jokinen L, Savela E, Parkkamäki S, Sandler C, Kalliomäki H, Dimitrow M. Policy and vision for community pharmacies in Finland: A roadmap towards enhanced integration and reduced costs. Pharm Pract (Granada) [Internet]. 2021 Feb. 4 [cited 2021 Oct. 20];19(1):2288. Available from: https://pharmacypractice.org/index.php/pp/article/view/2288

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