Basic Cream Scandal Reveals Systemic Problems

The recent discovery of individuals profiting from Kela-reimbursed basic creams on online marketplaces exposes a significant flaw in our system. This illicit business, particularly prevalent with pharmacy-exclusive basic creams that can cost up to thirty euros at the pharmacy but are sold for under ten euros online, highlights how easily subsidized products can be exploited for personal gain. It is concerning that while this issue has been known to pharmacies and Kela, platforms like Tori.fi were reportedly unaware until contacted by Yle.

The core of the problem lies in the accessibility of these creams through Kela reimbursements. When a customer's annual deductible for medications is met, they can acquire numerous basic cream packages for a mere 2.50 euros each. This means that a product sold online for eight euros is largely funded by the taxpayer through Kela. While basic creams are not strictly medications, their classification as pharmacy products in Finland has allowed for a lucrative pricing and sales model to be built around them by pharmacies and pharmaceutical companies.

This exploitation, likely driven in part by the current economic climate, raises fundamental questions about the rationality of the existing pharmacy model. The government's attempts to reform the pharmacy sector have been slow, hampered by lobbying from the Association of Finnish Pharmacies and constitutional court rulings that emphasize ensuring pharmacy profitability. This profitability is currently bolstered by sales of non-prescription self-care medicines and cosmetics, including these highly prescribed basic creams.

As some self-care medicines are set to be sold outside pharmacies starting next year—a move that has historically led to significant market share shifts away from pharmacies, as seen with nicotine replacement products—and with potential cuts to prescription drug pricing and changes to pharmacy taxes, the sustainability of some pharmacies is in question. The current system, which allows for such blatant exploitation of Kela reimbursements, needs urgent review. It is not just about preventing fraud but about ensuring that the system serves its intended purpose efficiently and equitably for all taxpayers and patients.