In and around Assen, eight pharmacies restrict competition
amongst themselves by refusing each other and possible new
pharmacies access during the day to their electronic data network
containing patient data. NMa has ordered these pharmacies on the
network to configure the network in such a way that all the
connected pharmacies can consult real-time patient information 24
hours a day on the network. If they do not comply with this order,
they will forfeit a penalty of EUR 1000 per day, subject to a
maximum of EUR 100,000 per participant.
In Tilburg, a joint venture involving 27 pharmacies,
Coöperatieve apotheken Midden-Brabant U.A., acquired a
polyclinic pharmacy, while there was also an external candidate. In
doing so, the parties prevented further competition. Existing
market relationships were consolidated by doing so. NMa has ordered
the pharmacies and their joint venture to cease operating the
polyclinic pharmacy and to transfer the operation of the pharmacy
to market players who do not have market power. If they do not do
so by the stipulated deadline, they will forfeit a penalty of EUR
1000 a day subject to a maximum of EUR 100,000 per
participant.
NMa takes action in the healthcare sector in areas in which
government policy makes the operation of market forces possible.
NMa focuses, in particular, on ensuring that entry by new players
is not obstructed and that competition between existing players is
not restricted. The latter includes the consolidation of existing
relationships where competition is possible.
The market for pharmaceutical services by pharmacies is
characterised by limited movements in the market, limited
inclination by patients to switch pharmacies and small differences
in the price of medicines. Since the scope for competition amongst
pharmacists was increased considerably in 2000 through an amendment
of the Medicines Act [Wet op de geneesmiddelenvoorziening], NMa
ensures that this scope is not restricted by existing players. NMa
only takes action in areas in which the government allows market
forces and where market players attempt to frustrate incipient
competition. The healthcare sector has priority in NMa's Agenda
2004.
The pharmacies in Assen have a shared electronic network
containing patient data. A network such as this can promote
competition since all the connected pharmacies have insight into
these data and are consequently able to ensure that patients
receive the right medicines (medication monitoring). This means
that patients receive optimal medication monitoring. This allows
patients to make use of a different pharmacy more easily. Since the
pharmacies in Assen agreed not to use the network during normal
opening hours, they restricted competition amongst themselves by
limiting patients' freedom of choice. In addition, by doing so they
obstructed the entry to the market of Wilhelmina Apotheek, at the
time a newcomer. After all, the quality of service provision by the
new pharmacy depends partly on the possibility of carrying out
optimal medication monitoring. In addition, this was a newcomer
which did not have an existing customer base amongst patients. As a
result, it was even more dependent on access to the network with
patients' data. To bring an end to this situation, NMa has ordered
the pharmacies in Assen to grant 24-hour access to the network
seven days a week by the stipulated deadline to all (potential)
participants and to provide them with real-time patient
information.
In Tilburg, all the existing pharmacies took on the operation of
the polyclinic pharmacy in the hospital, St. Elisabeth Ziekenhuis,
through a cooperative, after the hospital had taken the initiative
to set up a polyclinic pharmacy. Through the joint operation of the
polyclinic pharmacy by the existing pharmacies, the possibility of
a different candidate was excluded. Through the joint operation of
this polyclinic pharmacy, the existing pharmacies have no incentive
to compete with this pharmacy and inversely will not experience any
competitive pressure from the polyclinic pharmacy. This freezes the
market relationships between the parties and patients are not able
to benefit from the advantages of greater competition. To bring an
end to this situation, NMa has ordered the Tilburg cooperative of
pharmacies and its members to cease its operation of the polyclinic
pharmacy and to transfer it to one or more market players who do
not exercise market power.
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