Dipartimento di Ingegneria Industriale (DII), Università degli Studi di Napoli Federico II, P.le Tecchio 80, 80125 Napoli, Italy.
Facultad de Ciencias Económicas y Empresariales, Universidad de Navarra, Campus Universitario, 31080 Pamplona, Spain.
Health Policy. 2019 Nov;123(11):1108-1115. doi: 10.1016/j.healthpol.2019.08.010. Epub 2019 Aug 23.
Community pharmacies represent unusual enterprises as their main function is intrinsically related to the provision of healthcare services. Hence, market competition in this sector needs to be regulated, in order to ensure equitable accessibility, efficiency and quality of services. However, recently a general deregulation trend may be observed in Europe. In this paper, we focus on location restrictions, i.e. on demographic and geographic constraints to open new pharmacies, and we evaluate the impact of their relaxation. In particular, we analyze the case of the city of Pamplona (ES), where a striking increase in the number of pharmacies occurred, after the introduction of a new regulatory system in 2000. We evaluate, thanks to an in-depth spatial analysis, the evolution of the system to date and the effects produced on the consumers, in terms of accessibility, and on the competitors, in terms of market shares distribution. By comparing the obtained results with the ones related to the case of a second Spanish city, characterized by more strict restrictions, it emerges that the deregulation risks to produce a limited improvement in terms of accessibility and to exacerbate differences among consumers. Moreover, an increasing number of competitors does not necessarily imply a more equitable distribution of market shares, thus putting at risk the desired effects in terms of cost reduction and service quality improvement.
社区药房是一种特殊的企业，其主要功能与医疗保健服务的提供有着内在的联系。因此，需要对该领域的市场竞争进行监管，以确保服务的公平可及性、效率和质量。然而，最近在欧洲可能观察到了一种普遍的放松管制的趋势。本文重点关注地点限制，即开设新药房的人口和地理限制，并评估其放宽的影响。具体来说，我们分析了西班牙潘普洛纳市的情况，在 2000 年引入新的监管制度后，该市的药店数量显著增加。我们通过深入的空间分析来评估该系统迄今为止的发展情况以及对消费者（在可及性方面）和竞争对手（在市场份额分配方面）产生的影响。通过将获得的结果与另一个西班牙城市的情况进行比较，该城市的限制更为严格，结果表明，放松管制可能会导致可及性方面的改善有限，并加剧消费者之间的差异。此外，竞争对手的数量增加并不一定意味着市场份额的分配更加公平，从而危及成本降低和服务质量提高的预期效果。
