In many countries, pharmacists are already involved in vaccination, prevention and screening, monitoring of chronically ill patients and support for the correct use of medicines. On the occasion of World Pharmacists' Day, we ask the question: do we make full use of everything that a modern pharmacist can give to the patient?
World Pharmacists' Day is celebrated at the initiative of the International Federation of Pharmacy (FIP), which has member organizations from 157 countries and territories, representing over 5.5 million pharmacists and pharmacy teachers.
We talk about the topic with Master of Pharmacy Dimitar Kotsev, Chairman of the Board of RFK Sofia-Stolichna, and Master of Pharmacy Venelin Sapunarov, Council Member, FIP.
-Mr. Kotsev, happy holiday! Tell us how prevention can start in the pharmacy.
-Thank you! Happy World Pharmacists Day! I wish my colleagues health, professional success, public recognition and satisfaction.
Regarding prevention, in different countries pharmacists are involved in activities such as screening, vaccination, supporting people with chronic diseases, improving adherence to therapy and quitting smoking. This does not mean that the pharmacist replaces the doctor. It means that another medical professional is included in the patient's care. The difference is important. A person with an established disease must visit his doctor and be followed up according to medical indications. But between these visits, he repeatedly enters the pharmacy to get his medications. It is there that the questions may arise: “Is he taking them correctly? Is he missing doses? Is he having difficulties with the therapy? Does he understand how to use the medication?“. The pharmacist can support this follow-up, and when he identifies a deviation or risk — to refer the patient to a doctor.
This is already happening. In Germany, there is a pharmaceutical service for blood pressure control in patients with diagnosed hypertension. The measurements are performed according to a standardized algorithm, documented, and in case of deviations, the patient is referred to a doctor. In Denmark, pharmacies provide services for patients starting new treatment for a chronic disease, as well as support for problems with adherence to therapy.
What about vaccination in a pharmacy?
According to data cited by FIP, vaccination in pharmacies is offered in 56 countries and territories, and in 29 of them pharmacists can simultaneously administer and prescribe vaccines. Bulgaria is among the countries without an established regulatory framework for vaccination by pharmacists.
In France, the scale is indicative — During the 2024-2025 campaign, 6.6 million people were vaccinated against seasonal flu in pharmacies, with 90% of pharmacies participating. For the patient, the question is practical: how many accessible places are there around them where they can safely receive preventive care?
What would be the purpose of screening for diseases in the pharmacy?
Let's detect the risk in time. A person who feels healthy rarely visits a doctor just to check if they have an increased risk, but they may enter the pharmacy many times during the year.
In such activities, trained pharmacists can measure certain indicators and assess the risk, and in case of deviations, refer the person to a doctor. In this way, the pharmacist does not take the place of the doctor – on the contrary, it can help the patient reach the doctor on time.
Why doesn't this happen everywhere?
It is not enough for the pharmacist to have the necessary education. Appropriate legislation, sustainable financing and payment of services, integration into the health system, the necessary competencies and awareness of the public are needed.
This is precisely the theme of World Pharmacists Day in 2026 - – “Empowering pharmacists for healthier futures“. FIP calls for supportive policies, investments in education and the full integration of pharmacists into health systems.
Mr. Sapunarov, happy holiday! You are among the pharmacists who work to make September 25th recognizable in Bulgaria as well.
Happy holiday to all pharmacists! I sincerely wish my colleagues health and national and global recognition, success and sincere wishes for the holiday!
With constant efforts, we managed to make World Pharmacists Day more recognizable in our country, and for colleagues to feel part of the international pharmaceutical community. It is also an occasion to raise important questions for the profession and patients.
In connection with the increase in the cost of living, the question of how drug prices are determined in Bulgaria is once again relevant?
The prices of prescription and non-prescription medicines are some of the most regulated in Bulgaria compared to other products, which can have unlimited mark-ups. Pharmacists do not set the price of medicines. The state sets their price and anyone can check it in the registers on the NSCPRLP website https://portal.ncpr.bg/registers/. There they will see the price above which they cannot purchase a given medicine. If you find your medicine at a lower price - this is to your advantage. However, this does not apply to the nutritional supplements and cosmetics that fill the shelves of pharmacies and their websites.
It should be known that the mark-ups that pharmacies receive when working with medicines are some of the lowest in Europe and are set by the state and have nothing to do with market principles. For example, in any normal business, if you purchase a product at a certain price, for example 10.00 €, each retailer places their markup on this price. This is not the case with medicinal products; the pricing regulation obliges pharmacies to place their markup not on this price, but on the manufacturer's registered price, which is lower than 10.00 €. It is precisely the limited markups on medicines that are among the factors that prevent pharmacies from being able to support themselves and offer cosmetics, dietary supplements and other products for which the pricing is different. This is also the reason why pharmacies increasingly resemble shops.
Is pharmaceutical education changing in our country and does it meet European requirements?
Bulgarian pharmacists receive education that meets European requirements and successfully practice their profession in other EU countries. At the same time, the introduction of pharmaceutical services, which are already part of the practice in a number of countries, is lagging behind in our country. I hope that our efforts will lead to a change that will benefit patients and society.
In Bulgaria, master pharmacists study for no less than five and a half years, as required by the EU. Our diplomas are recognized when practicing the profession in other EU countries. Pharmacists, along with doctors and dentists, are trained at medical universities and are medical specialists. There is no bachelor's degree for pharmacists, just like in law, medicine, dentistry, architecture, veterinary medicine. From this academic year, there are also new disciplines in the specialty such as immunology, clinical pharmacy, ethical aspects of artificial intelligence, communication. This reflects the change of the profession and the increasing focus on patient care.
It is curious, however, that in Bulgaria there is a title left over from socialism: “pharmacist assistant“, where the training does not meet the EU requirements for pharmacy and often misleads patients, because it is a “professional bachelor“ and the title does not correspond to the profession of pharmacist. The new government in the country should eliminate this title and equate it with “pharmacy technician“, as they are in the EU and do not have the same regulation as pharmacists.
Let us end on a positive note. Bulgaria has well-prepared pharmacists and their potential can be used much more fully for the benefit of patients. I believe that with the development of pharmaceutical services, we can contribute to more accessible prevention, safer use of medicines and better care for people. This is precisely what the message of this year's campaign means - – “Strengthening the role of pharmacists for a healthier future“.