In Ukraine, pharmacies are obliged to ensure the dispensing of medicines exclusively by employees who have a pharmaceutical education and relevant qualifications. However, in real practice, an alarming practice has been taking shape in recent years: pharmacies do not have a full staff of specialists. This undermines the principles of safe pharmacotherapy, increases the risk of errors and weakens the responsibility for the consequences of the use of medicines. The situation that has developed is the result of systemic inaction at the level of state administration. In the presence of regulatory requirements, their compliance is not ensured, and the lack of response from the relevant bodies indicates the lack of actual institutional control.
Pharmacy reality under the crosshairs of inspections
It recently became is known, that the State Service for Medicinal Products and Narcotics Control (Derzhliksluzhba) has planned an inspection of pharmacy institutions for compliance with the requirements for the availability of qualified pharmacists. The basis for such an inspection was the discovery of a number of pharmacies in the first quarter of 2025 where there were no specialists who met the requirements for education and qualifications. In particular, this applies to pharmacies, where the dispensing of medicines is carried out by employees without specialized pharmaceutical education.
This problem is not an accident. The Ministry of Health of Ukraine (MOH) has long emphasized the importance of the presence of only qualified specialists in pharmacies, because their competence directly affects the safety of patients. Medicines sold without the supervision of a competent pharmacist can not only not help the patient, but also cause serious harm. This situation is potentially dangerous, as even minor errors in the dispensing of medicines can lead to serious medical complications.
The Ministry emphasizes that the dispensing of medicines without the participation of a pharmacist is a violation of the basic standards of pharmacy activity. Accordingly, pharmacies that do not comply with this standard will be subject to stricter inspections by the State Medical Service. Already at this stage, the EHOZ system (Unified Health Care System) has identified a number of pharmacies where specialists with pharmaceutical education do not work. Thanks to this electronic system, it is possible not only to identify pharmacy workers by their job duties, education and experience, but also to effectively monitor the fulfillment of license conditions.
How did it happen that our country has reached such a situation? The responsibility for it lies entirely with the state bodies, which were obliged to ensure compliance with the control. First of all, at the Cabinet of Ministers of Ukraine, which determines the general policy in the field of health care, as well as at the Ministry of Health, which was supposed to provide control and influence mechanisms in conditions of personnel shortage. This problem is not new, it has long been known to the Ministry since at least 2021, but no structural response to it has been formed. However, the government has not initiated any legislative or by-law initiative to ensure that such violations are prevented – by increasing supervision, establishing sanctions or introducing mandatory mechanisms to confirm professional presence during each shift. Also, no incentive mechanisms were created for pharmacy establishments to provide full-time professional staff, in particular, in conditions of shortage.
In addition, the State Service for Medicinal Products and Narcotics Control has the authority to conduct inspections of pharmacies, in particular regarding compliance with staffing requirements. However, the practice of such inspections in recent years has proven to be ineffective. Identified violations, as a rule, did not entail systemic consequences, and the inspections themselves were episodic and formal.
However, the problem is not limited to the availability or lack of qualified personnel. It also points to deeper systemic flaws in the organization of the pharmaceutical sector of Ukraine. Does the state have enough necessary measures to train and support qualified specialists? Are there adequate conditions for providing pharmacies with professionals with appropriate education? There are many such questions.
Pharmaceutical education in Ukraine
In Ukraine pharmaceutical education can be obtained at 17 institutions of higher education, in particular at the National Pharmaceutical University (NPU) in Kharkiv, which is a leader in this field. In addition, 6 institutions train specialists in the field of “Industrial Pharmacy”, and 32 institutions of higher education of the I-II levels of accreditation (medical schools and pharmaceutical colleges) train middle-level pharmacists. In general, there are more than 50 educational institutions training specialists in the field of pharmacy in Ukraine, providing the needs of more than 25,000 pharmacies.
It is worth noting that about 3-4 thousand students majoring in “Pharmacy” are graduated annually in Ukraine, which indicates a stable demand for this profession. However, despite the number of educational programs and graduates, the problem of a shortage of qualified personnel in the field of pharmacy remains relevant. Among the reasons are the outflow of young specialists from the profession, insufficient motivation to stay in the field due to low salaries, as well as a gap between theoretical training in educational institutions and the real requirements of employers.
Among the frequent ideas about the pharmacist’s profession, there is still a misconception that his place is exclusively behind the pharmacy counter. In fact, the range of opportunities for specialists in this field is much wider. Pharmacists can work not only in pharmacies, but also in drug warehouses, in the production units of pharmaceutical companies, in laboratories, online stores that sell medical products, as well as in the educational system and research institutions.
At the beginning of 2024, the employment portal work.ua published 928 open vacancies for pharmaceutical specialists. The average salary level in the market was UAH 20,000. At the same time, this figure varies significantly depending on the region and specific employer. In Kyiv, pharmacists are offered salaries from UAH 22,000, in Dnipro – from UAH 21,500, and in Lviv – about UAH 19,000.
In most vacancies, employers make typical requirements for candidates. First of all, it is the availability of pharmaceutical education. Quite often, companies are willing to consider candidates who are still studying, but already in senior years. Personal computer skills, including Microsoft Office, are also required, as well as the ability to navigate medicines: to select analogues taking into account dosages and forms of release. A specialist applying for the post of pharmacist must have knowledge of a number of fundamental disciplines.
These are, in particular, pharmacy drug technology, pharmaceutical chemistry, pharmacology, as well as economics and organization of pharmaceutical activity. The responsibilities of pharmacists working in pharmacies usually cover several areas. The main ones are the sale of medicines and related products, keeping documentation, accounting for defective goods, accepting new batches of medicines. The consultation function also plays an important role: pharmacists must provide buyers with comprehensive information on the use of drugs. Daily responsibilities also include maintaining order in the sales hall, on the shelves and in the warehouse, and in the conditions of modern digital trade, also processing online orders.
Pharmacists in administrative positions, such as pharmacy managers, have a wider range of responsibilities. They are responsible for the formation of the range of medicines, ensure the efficient functioning of the pharmacy, monitor compliance with the conditions of storage of medicines, organize the work of the staff and monitor the timely replenishment of stock.
Thus, the profession of a pharmacist is far from just working at the cash register or selling pills. This is a complex, multidisciplinary specialty that requires serious training, responsibility and the ability to work both with people and with precise technological and administrative processes. But the situation with a shortage of specialists in this field indicates the need not only for the quantitative supply of personnel, but also for a qualitative rethinking of the training of pharmacists: modernization of educational programs, improvement of the practical component of education, as well as the creation of conditions under which work in a pharmacy will be attractive from both a professional and an economic point of view.
One of the key initiatives to address these issues is the launch of a register of pharmacists. This will allow not only to unify the database of employees of pharmacy institutions, but also to create a transparent system of monitoring human resources in the medical field. The EHC system will help increase the transparency of this process and integrate data on pharmacists into a single register of medical workers, which will certainly increase citizens’ trust in the health care system.
However, even this step is not a panacea. The main problem remains the insufficient number of highly qualified personnel. In this regard, only inspections and the granting of licenses cannot be dispensed with. The system of training pharmacists needs real reforms. Educational institutions should provide not only basic knowledge, but also practical skills that meet the requirements of modern pharmaceutical activity. It is necessary to create incentives to attract young specialists to pharmacy practice and to ensure that the pharmacist profession becomes prestigious and financially attractive.
In turn, control over compliance with the requirements for the qualification of pharmacy workers should become more systematic and regular, and not be limited to individual inspections. Only a comprehensive approach will allow us to create an effective model of providing pharmacists in the pharmacy network, where each patient will be sure that the medicine is dispensed by a qualified specialist.
How pharmacies worked before 1991
Previously, the pharmacy system was not a profitable business, it represented a part of the state medical machine – centralized, bureaucratized, but structured to the bone. Pharmacies did not belong to private individuals, they were state property and subordinated to the Ministry of Health, and locally to the relevant regional health departments. At the same time, the main task of the pharmacy was not to make a profit, but to provide the population with medicines, which, by the way, were also produced exclusively at state-owned pharmaceutical factories. No foreign brands, no marketing or “promotions on antipyretics”, everything appeared clearly according to the list agreed by the ministry. Yes, there was not such a variety of drugs before, but there was strict control over the industry.
It is important to understand that in those days it was impossible to get into a pharmacy without a diploma. Education was mandatory: pharmacists and pharmacists acquired a specialty at medical institutes and pharmaceutical technical schools. Internships, exams, tests – everything is as it should be. The pharmacist had a clearly defined area of responsibility. A technical school graduate could work as a pharmacist, but not as a manager. For this, it was necessary to obtain a higher education, accumulate experience and loyalty to the system. Moreover, drug manufacturing laboratories also worked in pharmacies. If the necessary medicines were not on the shelves of pharmacies, they were made according to a doctor’s prescription directly in the pharmacy. For this purpose, there were separate workers — galenic and assistant pharmacists who knew the technologies and made solutions, tinctures, ointments, and even candles. Unfortunately, there is no such thing now, because it is unprofitable. This level of expertise is now found only in specialized hospital pharmacies.
In addition, inspections in pharmacies were regular and strict. Everything was thoroughly checked – from the correct storage of drugs to the availability of sanitary logs. An extra bottle of alcohol could have been the cause of a strict interrogation, why it was not taken into account. The drug with a deadline that coincides in a month had to be written off or handed over urgently, and not to appease the poor buyer. Although there was no electronic record keeping system in those days, the Soviet system did not allow for failures and inaccuracies. Disciplinary sanctions, dismissal or, in case of serious abuses, criminal liability were imposed for violations. The pharmacy was an institution of the medical system, not a trading floor.
But over time, pharmacy establishments passed into private hands, some were looted, some were privatized or repurposed. Licensing began to work, but without a strong control system. There was an outflow of personnel — many specialists with diplomas simply left the pharmacy field, disappointed in the level of salaries and prospects. However, the system did not degrade instantly, but gradually, losing what was once the norm: professionalism, control and responsibility.
Standards and role of pharmacists in different countries
It is worth noting that the pharmacy business cannot be perceived as a simple commercial activity, because it is part of the medical infrastructure that directly affects the health of citizens. In Ukraine, the question of qualification of pharmacy workers has become relevant only recently. Let’s look at the experience of other countries and find out how the pharmacy business is organized abroad.
In Europe, the pharmacy business is clearly regulated, and qualification requirements for pharmacy workers are one of the main conditions for obtaining a license. For example, in Germany, France and Great Britain, pharmacy staff must have pharmaceutical education. This is not just a formality, but a guarantee that patients receive qualified assistance in the process of dispensing medicines. In these countries, a pharmacist is not just a person who dispenses medicine, but a key figure in the process of counseling patients. They have knowledge not only about the drugs themselves, but also about drug interactions, possible side effects and correct dosage. In Great Britain, pharmacists are required to constantly update their knowledge through a system of continuing professional education, which helps them stay abreast of the latest medical advances. In Germany and France, the system of certification and licensing of pharmacists is strict. To become a pharmacist, it is necessary to complete several years of university studies, as well as to undergo serious practical training. In addition, pharmacists are required to pass exams confirming their qualifications and regularly take advanced training courses.
In the USA, the situation is similar, although here there is a certain freedom of choice as to who exactly should work in the pharmacy, in practice, most pharmacies have a staff of pharmacists with appropriate education. In most states, laws require only a licensed pharmacist to dispense medication, which can only be obtained after completing a training program at an accredited educational institution. However, in the US there are some differences in approaches depending on the state. For example, some states allow pharmaceutical assistants with less qualifications to work in pharmacies.
However, even they must undergo training that includes the basics of pharmacy, pharmacy logistics and customer interaction. At the same time, the pharmacist will always remain the main figure for advisory services and decision-making. In most states of the United States, in order to work in a pharmacy, you need to undergo certification and training that meets national standards. At the same time, pharmacists here, in addition to dispensing medications, also manage medications, monitor their safety, and can provide recommendations on dosages and drug interactions.
Japan also has a clear system of control over the pharmaceutical business. Here, pharmacists are perceived as important advisors in the treatment process. As in Europe, in order to work in a pharmacy, it is necessary to complete several years of university studies, pass exams and obtain a license. In Japan, the system of pharmacists works in close cooperation with doctors. And although the role of pharmacists is critical, some large pharmacy chains create additional training courses for their employees, which allows to improve the qualifications of even those who do not have a formal pharmacy diploma. However, this is an exception, and the vast majority of pharmacy workers are specialists with specialized education.
In many countries of Latin America and Asia, the situation is somewhat different. For example, in India and Pakistan, some pharmacies may hire workers with minimal or no pharmaceutical education if they have completed specialized courses and have work experience. However, even in these countries there are state programs that provide training for pharmacists to work in the pharmacy network. And although pharmacists in these countries may not have the same level of training as in developed countries, control over their activities still exists, and some pharmacies are required to work exclusively with licensed specialists.
As you can see, regardless of the country, the pharmacy business all over the world has a well-defined role of the pharmacist as the main specialist who not only dispenses medicines, but also advises patients on their use, dosage and possible side effects. Although some countries allow less skilled workers, most pharmacies operate under standards that require only certified pharmacists to be on staff. This approach is due to high standards of patient safety, and also ensures trust in medical and pharmaceutical institutions.
The situation that has developed in the Ukrainian pharmacy sector has long exceeded the level of a local personnel crisis, becoming a litmus test of deeper systemic failures. The presence or absence of a licensed pharmacist in a pharmacy is not a trifle that can be ignored, but a critically important factor that directly affects people’s health and safety. While most civilized countries build a pharmacy business based on knowledge, experience and certified qualifications, in Ukraine this sector is increasingly turning into another commercial experiment with minimal responsibility.
