More than 100 Finnish pharmacies at risk under new reforms

When Finland’s Minister of Social Security, Sanni Grahn-Laasonen, outlined the government’s latest pharmacy reform package in early 2025, she described it as a careful step toward modernisation.

But for a country with one of the world’s most tightly regulated pharmacy systems, even modest changes carry weight. Finland’s model is built on pharmacies owned by individual pharmacists, each operating under a licence assigned to a defined local area.

Unlike Sweden and Norway, where deregulation opened the door to supermarket chains and the market domination by a small number of vertically integrated corporations, Finland has maintained a structure designed to guarantee nationwide access, especially in remote communities.

On December 30, however, Finland’s Ministry of Social Affairs and Health confirmed the country’s Parliament and President had ratified a package of laws and decrees aimed at modernising pharmacy economics, reducing government spending and expanding sales channels for some overthecounter medicines.

The reforms, which begin rolling out from 2026, represent the most significant shift in Finland’s pharmacy framework in more than a decade.

System under strain

Finland’s pharmacy network is built on privately owned, pharmacist-run businesses operating under licences tied to specific geographic areas. The Finnish Medicines Agency (Fimea) controls where pharmacies may open to ensure coverage across the country’s 309 municipalities.

Medicine prices are regulated through a national tariff — the price charged for a medicine by a wholesaler must be the same for every pharmacy. The funding arrangements include a progressive pharmacy tax which redistributes the overall income base from larger urban pharmacies to smaller rural ones.

For the 2025 tax year, pharmacies paid a sliding scale percentage of their turnover to the government, with the rate set at rates starting at zero for the smallest pharmacies to 11.2 percent for those with turnovers exceeding six million euros.

The government’s reform package centres on two major changes: cutting the medicine tariff for prescription medicines and changing the pharmacy tax system so that it is calculated based on gross profit margin from medicine sales, rather than turnover.

According to the ministry, the tariff cut will reduce government reimbursement costs by about 30 million euros annually and lower consumer medicine costs by roughly six million euros per year. Much of this burden will fall on pharmacy owners.

“The new pharmacy tax will be progressive, just like the current pharmacy tax. Pharmacies with a profit margin of less than 250,000 euros will be completely exempt,” the ministry said in its release.

Gross profit margin exceeding 1.7 million euros – the top of the new scale — will attract a tax of 43 percent. This major restructuring will create winners and losers depending on size and sales mix.

OTC sales widen

From 2027, pharmaceutical companies will be able to apply for permission to sell a limited range of lowrisk over-the-counter medicines outside pharmacies. The ministry said the list includes products for heartburn, constipation and dry eyes.

These medicines will be exempt from pharmacy tax and may be sold at discounted prices, although maximum price regulation will still apply.

The reforms also give pharmacies new authority to correct obvious errors in prescriptions and to deviate from prescriptions in cases such as nationwide supply disruptions or the withdrawal of a medicine from the market.

Financial risks rise

While the government argues the changes will improve efficiency and strengthen the long-term sustainability of the medicines system, Fimea’s updated modelling suggests the reforms could strain the country’s pharmacy network, particularly in rural areas.

In an assessment reported by public broadcaster Yle, Fimea said the reforms “pose a serious threat to the business at more than 100 pharmacies in Finland”. The agency found 38 pharmacies are at risk of becoming unprofitable, while another 79 could see annual revenue fall below 100,000 euros — a level Fimea considers insufficient to cover a pharmacist’s salary and basic operating costs.

Fimea also identified 27 pharmacies with turnover below 100,000 euros as “critical” for regional access because they are the only pharmacy in their municipality or area. The agency said it could not disclose their locations due to financial confidentiality rules.

“I can say that they are all over Finland, so they’re not concentrated in any particular area,” Juha Sinnemäki, a unit chief at Fimea, told STT, the Finnish News Agency. STT is Finland’s national wire service supplying news to media outlets across the country.

Access concerns grow

The warnings highlight the tension between the government’s push for cost savings and Finland’s long-standing commitment to territorial equality in healthcare access. For decades, pharmacy regulation has ensured even sparsely populated regions maintain at least one pharmacy, with Fimea using licensing powers to prevent gaps in coverage.

The ministry said the reforms were designed to be implemented “responsibly and gradually,” ensuring the availability of safe and highquality pharmacy services nationwide. A second legislative proposal on pharmacy operations is expected later in the parliamentary term.

Pharmacy owners, represented by the Association of Finnish Pharmacies (AFP, a member of the World Pharmacy Council), have previously cautioned that economic pressures are already mounting. Pharmacies’ finances have been weakened by previous funding cuts, rising costs, and a long-term decline in the prices of prescription drugs.

Presciption volumes have risen sharply in recent years, while medicine prices have fallen and staffing shortages have intensified. Many small pharmacies, including those in rural areas, rely on revenue from overthecounter products and private prescriptions to remain viable.

Impact from 2026

As the changes roll out, the impact on Finland’s pharmacy network will be closely watched. Fimea’s modelling suggests that some municipalities could lose their only pharmacy, forcing residents — particularly older people and those without transport — to travel further for essential medicines and counselling.

The government maintains that the reforms will create a more costeffective distribution system while safeguarding regional access and medication safety. The effects will become clearer as the new tax structure and OTC sales rules take effect from 2026 onwards.