Estonia is planning to introduce pharmacy vending machines that would dispense both over-the-counter and prescription medicines.
The goal of pharmacy vending machines is straightforward — to improve access to medicines. Under the draft, one general pharmacy license could include up to five machines. In a settlement with more than 4,000 residents, one machine would be allowed, and it would have to be located at the same site as the general pharmacy.
In settlements with fewer than 4,000 residents, a machine could be located either at the same site as the general pharmacy or at least one kilometer away from another pharmacy owned by a different operator.
In addition to the Ministry of Social Affairs, the Ministry of Economic Affairs and the state innovation accelerator are also behind the changes. But some pharmacists said they do not understand what problem these machines are meant to solve — especially since the machines are expensive and their payback period is uncertain.
In the past, Estonia has experimented with both bank buses and pharmacy buses, and both have since been abandoned.
Former ministers’ opinions differ
Former social minister and Reform Party member Signe Riisalo said she believes the plan is a good one: “Maintaining a physical pharmacy in many different locations is costly. But these machines provide very good accessibility. And they are designed to include the possibility of consulting a pharmacist.”
Riisalo noted that the Riigikogu Social Affairs Committee has not yet discussed the draft in detail, but the initial presentation convinced her that such a system could work.
“Keeping a real pharmacy open is certainly more expensive when you consider rent and labor costs,” Riisalo said. “We’re talking about a machine with a high initial cost, yes. But the ongoing costs are lower, and it brings services closer to people.”
Former social minister and Social Democrat Riina Sikkut said the idea of allowing pharmacy machines has been discussed for a long time. “I have not yet seen a need to replace pharmacists with machines. Especially in smaller places, it’s important that pharmacies remain open and that there is a pharmacist who can give advice. Technological development does create pressure to change the legal framework, but there must be very strong arguments for allowing machines alongside pharmacist‑run pharmacies,” Sikkut said.
Sikkut said the need for such machines is unclear: “If there were such a big demand for medicines at night, we would have 24‑hour pharmacies. But we don’t. And most people, as crisis guidelines recommend, already keep basic medicines at home for everyday health issues.”
Pharmacies can outsource medicine preparation
The bill includes other important changes, such as easing the requirement to prepare medicines on site.
Until now, general pharmacies in larger towns were required to have rooms and equipment for preparing medicines on site, even though most of them did not actually do so. The new bill gives pharmacies flexibility to meet this requirement through an agreement with another general pharmacy, meaning they can outsource the preparation of medicines. Access for patients will not worsen because the obligation to accept prescriptions and hand out the finished medicine will remain with the pharmacy in the patient’s home area.
The bill also changes the role of hospital pharmacies and expands their rights.
Hospital pharmacies often have broader capabilities and better technologies, such as 3D printers, for preparing specialized medicines than regular general pharmacies.
The amendment allows general pharmacies to order the preparation of more complex extemporaneous medicines directly from a hospital pharmacy so patients can receive suitable medicines close to home. Hospital pharmacies will also be allowed to supply their prepared medicines to private clinics and other healthcare providers.
Courier delivery of medicines is still being developed
Although the bill does not include the earlier idea that food couriers could deliver medicines to customers, the state has not abandoned the plan.
“The idea that medicines could in the future reach people through platforms like Wolt or Bolt has not been dropped. However, it is important to clarify that the recent amendments to the Medicines Act sent for approval by the Ministry of Social Affairs concern self-service pharmacies and are not intended to address this specific service model,” said Joosep Kään, head of administration and development at Accelerate Estonia, the development lab of the Ministry of Economic Affairs.
Kään said the issue with Wolt and Bolt is not that they would start selling medicines themselves or take over the role of a pharmacy.
“Based on the current analysis, the existing legislation already allows a model where the seller and responsible party remains the pharmacy with the right to conduct distance sales, while the platform serves as an additional sales channel and delivery intermediary. All requirements related to the sale of medicines would remain in place, including pharmacist counseling, correct display of medicine information, safe handling and the pharmacy’s responsibility,” he said.
In this model, Wolt and Bolt can act as intermediaries connecting the buyer, the pharmacy and the courier, Kään said.
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