Dear Sir or Madam, We hear all the time how the health insurance system is unsustainable and it is necessary to cut the rights of citizens so that the Health Insurance Fund does not go bankrupt. Limiting and cutting rights is, of course, absolutely necessary in such cases if we really do not want to have problems with the health coffers, but I have not been able to find out how the cost side of health care is going to be reduced, apart from prescribing the cheapest medicines.
My own experience: for a long time our company (d.o.o.) has been stocking pharmacies around Slovenia with certain products, but we have encountered a rather incomprehensible obstacle - the wholesalers (Salus, Kemofarmacija, Farmadent and Grosist LL). The pharmacies themselves were not willing/unable to buy goods from us at significantly lower prices when they bought them from the wholesalers.
 
They basically "ensure" that the price of medicines and other products in pharmacies is sold at significantly higher prices than would otherwise be the case if the manufacturers were to supply the pharmacies directly. As an example, one of our products was sold in pharmacies at a margin of more than 200%, which is unacceptable. How the wholesalers justify their margin is not clear to me, as they themselves have no or extremely low stocks, so they basically charge a commission just because they exist and collect orders and forward them to the suppliers and then distribute them themselves - which the suppliers could do themselves (we have the same system with other retailers in SLO).
PROPOSAL:
 
If we were to abolish or significantly limit wholesaler margins, dear Government, this would significantly help the liquidity of the health coffers and stop slowly hitting the people because we are going to run out of money! You certainly have the power to limit profits, because pharmacies are public institutions and the operation of public institutions is regulated by law, the only question is whether there is a political interest. I do not see it!
For a better understanding of my proposal, please read the article "Pharmaceutical chain: a new wholesaler enters an attractive 600 million market" (Source: Manager, No. 4 2011; Author: Mihael Šorl).
And a quote from the above article:
"The big three share the market
Until last year, the wholesale market for medicines was shared by three wholesalers: Kemofarmacija, Salus and Farmadent. In 2009, Salus had a turnover of €222 million and a profit of €6.1 million, while Kemofarmacija had a turnover of €292 million and a profit of more than €9 million. Kemofarmacija thus had a 42 % market share, Salus a 33 % market share and Farmadent a market share of around 15 %. "
"How drug prices are built
According to the Pharmacy Chamber, in developed European countries (Denmark, the Netherlands, Italy, Austria, Germany, the UK, Finland, Spain, Belgium), the share of pharmacies in prescription medicines is 21.6 per cent, while in our country it is 7.5 per cent on average. While in developed European countries, wholesalers get only a 6.3% share of prescription drugs and manufacturers 63.6%, in our country the combined share of wholesalers and manufacturers is 84%, i.e. 14% higher. We have no information on how the 84% is to be divided between the manufacturer and the wholesaler (the manufacturer's share is rising for more expensive medicines, while the wholesaler's share is falling for more expensive medicines, see table). While the translation of instructions, which the wholesaler has to take care of, is more expensive in Slovenia than in countries with larger language groups, on the other hand, it is a reliable business, with the state as the payer, so the risk is low. "