Saddled by a debt of nearly five billion Slovak crowns, Slovak pharmacists staged a one week strike at the end of May, to demand that their financial crisis be dealt with by the government.
The problem lies with prescription drugs - medicine prescribed by doctors which is partly or completely covered by state and private health insurance firms. By law, pharmacists must give drugs to patients who present prescriptions. But payments from health insurers to the pharmacies are routinely late, leaving the latter with no money to buy the drugs they must distribute.
Drug suppliers have long allowed the cash-strapped pharmacists to delay payments to them in return. But the practice has resulted in a debt of 4.8 billion crowns ($96 million) as of the end of February, and has left the suppliers themselves unable to pay the original manufacturers of drugs.
The chain of debt finally snapped in May, with pressure coming from the bottom up to force the main non-payers - the health insurance firms - to cough up.
"The producers are demanding payments from us," said Jozef Pospíšil, head of the Drug Suppliers Association (ADL). "As a result, we will have to start selling drugs to pharmacies [and forego the delayed payment agreements]."
The strike produced limited action, with Health Minister Roman Kováč promising May 24 that the state would cover 2.5 billion crowns of the debt with revenues from the privatisations of the Dudince and Piešťany spas, scheduled for this autumn.
Pharmacists, however, were not satisfied. A few days later, they threatened to begin charging patients for prescription drugs if the debt was not dealt with.
Health Ministry representatives responded that charging patients would not only be illegal, but would prohibit "some 99% of the nation's inhabitants from buying their medicine, as they cannot afford the drugs," said Ján Šipeky, head of the ministry's pharmaceutical section.
Health Minister Kováč added that pharmacists who charge for drugs would have their licences stripped.
The impasse was still being debated as the end of June approached.
