Agenda Profile: Irja Lutsar

The core political stance revolves around an amendment to the Medicines Act that would grant hospital pharmacies the right to direct procurement. The representative of Eesti 200 expresses moderate opposition to the draft bill's broad scope, instead favoring a narrower application focused specifically on life-saving drugs, crisis situations, or rare diseases. This position is strongly policy-driven, underscoring the necessity of maintaining reasonable competition and short supply chains. The initial momentum for the bill originated from the previous government's austerity measures, which sought cost-saving opportunities through joint procurement.

The speakers exhibit a deep understanding of pharmaceutical market regulation, supply chains, and the competitive situation in Estonia, citing the two predominant wholesalers and the analyses performed by the Competition Authority. Specific terminology is used, including "rare diseases," "outpatient network," and "radiopharmaceuticals." The discussion also touches upon bureaucratic procedures, such as marketing authorization applications and objective metrics for subsequent evaluation.

The style is formal, analytical, and cautious, particularly concerning the stance of Eesti 200, which emphasizes risks (monopolies and amateurs). The rapporteur (Speech 2) employs a neutral and descriptive tone, reflecting the lively and constructive discussion held within the Social Affairs Committee. The argumentation is strongly logical and evidence-based, focusing on the mechanisms of the bill and its potential consequences.

The course of action focuses on legislative work, including participation in the Social Affairs Committee meeting (October 14) and the presentation of the draft bill to the Riigikogu plenary session (October 23) for its first reading. One speaker has been appointed as the representative of the lead committee. The first speech will focus on addressing practical shortcomings in the organization of outpatient care.

The criticism targets the broad scope of the draft bill, which could nationalize a third of the pharmaceutical market and increase the workload and bureaucracy for hospitals. The representative of Eesti 200 also criticized the minister's sometimes ambivalent messaging and warned that monopolies and amateurs are not the best tools for solving problems. The criticism is aimed at the political scope, not the individuals involved.

The Social Affairs Committee held a lively and constructive discussion, resulting in consensus decisions regarding the inclusion of the draft bill on the plenary session agenda and the completion of its first reading. Eesti 200 is proposing a specific alternative solution (narrow wording), which signals a readiness to compromise on the scope of the draft bill.

The focus is on the national level (the Estonian pharmaceutical market and 24 hospital pharmacies) and international comparison, referencing the Finnish experience and European wholesalers. There is no regional or local emphasis within Estonia present in the discussions.

Economic arguments emphasize opening the market to competition to ensure lower prices for pharmaceuticals and shorter supply chains. Concerns are being raised that the draft bill could nationalize one-third of the drug market, which has previously operated under private enterprise. It is questioned whether the bill will lead to significant cost savings or a drop in prices.

The primary social concern revolves around the accessibility and continuity of medication, particularly for patients suffering from rare diseases whose needs are becoming increasingly complex. Emphasis is also placed on ensuring the continuation of treatment for chronic conditions when patients transition from hospital care to the outpatient setting. The objective is to improve treatment outcomes and safeguard patient interests.

The legislative focus is currently on the draft Act amending the Medicinal Products Act (501 SE), the objective of which is to grant hospital pharmacies broader rights of importation. A representative of Eesti 200 supports the bill but seeks to narrow its scope to prevent excessive market intervention. For the ex-post evaluation of the bill, plans are underway to assess the number of instances and the financial volume associated with the use of the import right.