A new European-wide study of community pharmacy before and after the Covid-19 pandemic sheds light on the development services within the profession. Niamh Cahill reports
The evolution of community pharmacy across Europe is clearly illustrated in a new study published recently in the International Journal of Clinical Pharmacy.
Titled: ‘Evolution of Community Pharmacy Services in the European Union and Beyond: A Cross-country Survey of 33 National Pharmacy Organisations’, the study compares information gleaned from surveys in 2025 with pre-pandemic (2020) survey data.
The study’s authors – including Martin Henman, Adjunct Associate Professor in the Practice of Pharmacy at the School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD) – wanted to examine trends in service provision, reimbursement, and regulatory barriers from a health policy perspective.
In order to do this, a cross-sectional survey was conducted among national pharmacy associations in all 27 EU Member States and in six neighbouring countries.
Data was gathered and mapped on 47 community pharmacy services and information on the reimbursement status for services, and their level of implementation was also collected.
Expansion
The results reveal that between 2020 and 2025, community pharmacy services have expanded across Europe, with the increase in services largely dependent on public remuneration and supportive regulatory frameworks, the authors concluded.
Speaking to Irish Pharmacist (IP), Prof Henman stated that there are not many studies of this kind conducted at EU level which provide information about the availability of community pharmacy services in Europe.
Speaking from an Irish perspective, Prof Henman said the study showed how services had grown in Ireland during the five-year period, which was due to a number of factors, including the persistence of the Irish Pharmacy Union (IPU) in seeking greater supports for community pharmacy and producing the Community Pharmacy Agreement 2025, he said.
“Persistence is the key thing, because in some respects, and compared to the UK, Ireland had very few services that were supported in any way by the Government. That meant the scope of practice of community pharmacists would have been more limited,” Prof Henman said.
“Some other countries began to make significant moves in these areas over the last few years. In some ways Ireland, whilst as individuals, community pharmacists were quite progressive, [but] you can’t sustain those services on an individual pharmacy-by-pharmacy basis – they have got to be recognised by the health service, and you need some support there because that helps people and patients to see that the pharmacy is a part of the health service.”
Vaccinations
“The IPU has been very successful in the last few years because they’ve been persistent, particularly since Covid. And in a sense vaccination services, that began before Covid, were a very good thing because it began to show the health service that people going to pharmacies to be vaccinated were not necessarily always the same people who in previous years would have gone to their GP. That meant you were expanding the number of people who are getting vaccinated.”
Prof Henman added that the Covid-19 vaccination scheme in pharmacies “went extremely well” and helped to set the scene for future developments in pharmacy services.
Another factor related to the boost in community services in recent years has been the recognition that the number of GPs is not keeping pace with population increases, Prof Henman said.
Several European countries have a lot of older GPs who will retire from practice in the next few years, he said, posing challenges for primary care services.
“That also, in a sense, has begun to push governments to think about finding other ways, and one of those ways is asking community pharmacists to do more,” Prof Henman outlined.
Jorge Batista, Senior Professional Affairs Adviser with the Pharmaceutical Group of the European Union (PGEU), and study author, told IP that studies like this one support the “professional evolution of community pharmacy by demonstrating that the community pharmacy profession is moving beyond the traditional dispensing towards a broader clinical and public health role.
“Furthermore, this study highlights the shift from a more product-based model to a service-based model of care, supporting a case where community pharmacists can expand the scope of their practice where appropriate.”
Mr Batista said the most striking finding from the study was that 77 per cent of the mapped services (out of a total of 47) were available in more countries in 2025 than in 2020, with strong growth in vaccination, medication reconciliation, and first-time dispensing interventions.
Maturing Service Provision
“This shows that the expansion of community pharmacy services is not isolated, but a broader trend. Furthermore, this growth has happened in a relatively short time frame – five years only. In general, we see an increase in the number of countries offering pharmacy services, and also that countries are maturing their service provision.
“We see cases of countries that in 2020 were offering the service as a pilot, and in 2025, the service has expanded to national-level implementation. This is also important, as increasing service maturity allows for sustainable implementation.
“On the other hand, we found surprising the uneven implementation of community pharmacy services across the countries. Even though the median was 26 services per country, the range was wide, between nine and 43 services. This shows a great potential, but also a lack of harmonisation.
“The wide range in the number of services per country suggests that patients’ access to pharmacy-based care still depends heavily on where they live. A clear need for more co-ordinated policy development stands out, which is why these type of studies are important to shed some light into practice development and inspire policy changes. The next policy challenge is not only whether pharmacists are allowed to provide services, but whether these services are properly commissioned, remunerated, and integrated into primary care.”
The results show that Ireland, in general, provides a broad range of services in community pharmacy. Some services and support provided in other EU countries, however, such as medication reviews and shared electronic patient records, for example, are absent.
Mr Batista said the evolution of pharmacy services during and after the Covid-19 pandemic was mainly positive, but more nuanced than it appears at first.
“While during the pandemic, many parts of the healthcare system were under pressure, community pharmacists remained highly accessible, despite extremely challenging conditions. Community pharmacies kept their doors open, continuing to provide services to the population,” Mr Batista outlined.
“The Covid-19 pandemic created a space where existing trends were able to accelerate and get increased public and political recognition for community pharmacists and other essential healthcare professionals. It showed that community pharmacists were ready to take on these additional services in a safe and responsible manner, when regulations allowed it. It created a momentum for vaccination, prescription renewals, and medicine shortage management, among other services that gained popularity during that time.
“Our findings show that regulatory changes occurred around the Covid-19 pandemic period – and whilst the pandemic itself was not positive, it created a policy window in which pharmacists’ accessibility and readiness became more visible.”
Prof Henman said in the future, it will be interesting to see to what extent new services were being used by the public and taken up by pharmacists.
“The difficulty for community pharmacies, which are independent, is that they are small- to medium-sized enterprises and they can be squeezed. There are a number of economic and business-related factors at play, so it can be difficult for them to manage that,” Prof Henman said about the factors related to service take-up by pharmacies.
Prof Henman mentioned that in Germany, a patient medication review service had been introduced there with government support, but that to date it had proved challenging to get pharmacists there to take up the service.
“The case in Germany suggests that even with government support, there is still more work to be done to persuade people that they should be looking for this, to create the demand, and convince pharmacists that they should stick their neck out, in a sense, and attempt to do it.”
Future Research
Mr Batista said the study clearly demonstrated that the role of community pharmacists was changing and that, in most countries, service provision was becoming an embedded feature of the profession.
He added that future research should aim to evaluate the clinical impact of these services and provide evidence not only of the availability, but also the improved outcomes, especially from a patient perspective.
“Bringing a clear view of the economic value, the reduced pressure on the healthcare system, and cost-effectiveness of these community pharmacy services can create a basis for future regulations. Above all, the sustainable implementation of these services will also depend on service reimbursement, recognising the role of community pharmacists in primary care,” Mr Batista stated.
“As European health systems are facing growing challenges, such as ageing populations, workforce shortages, medicine shortages, chronic disease burden, and constrained budgets, this research highlights the accessibility of community pharmacists and the current and future potential of community pharmacists in relieving pressure on primary care by supporting prevention, medicines optimisation, screening, and patient counselling.”
