Thursday, March 28

The town apothecary who lost his usual clients after a secret pact | Madrid


As in any village pharmacy, in Juan Gil’s everyone is greeted by name. They talk about health, work, children and grandchildren. There is so much trust that Juan Gil has shared Christmas Eve dinner with some lifelong clients. Those who have been buying for 52 years, since their father opened the first apothecary in Villa del Prado in 1969, a town of 6,661 inhabitants in the west of the Madrid region. But every time an elderly neighbor enters the public residence in the same town, just 350 meters from his establishment, they cease to be his clients and go over to the competition, the other pharmacy in Villa del Prado, a franchise of the Trébol group which takes much less time in the municipality. Just when they reach old age, the stage of life when they need drugs the most, Gil loses them forever.

Gil is 56 years old and is the son of Don Miguel, the apothecary who opened the business. It was the year 2003 when the Gils had good news and bad news. The good news was that the Community of Madrid opened a public residence for the elderly with 120 places in the town, just three minutes from its establishment, down Calle del Álamo. These homes for the elderly are a big business for pharmacies anywhere in Spain, because elderly people generally consume more medicine than young people, as they suffer from chronic diseases such as hypertension, diabetes or arthritis.

The bad news was that a little before that time competition had just arisen for the first time in Villa del Prado itself, a pharmacy that provides service a little further up, 700 meters from the residence up the Avenida de España, so known as Avenida del Generalissimo. That’s when Gil began to notice that his longtime clients turned their backs on him and at first he didn’t understand why. The reason, as he found out by asking about the town, was in the pact that the rival pharmacy and the home for the elderly had agreed upon. The public residence is managed by a private company, Sacyr Social, a subsidiary of Spanish construction giant Sacyr, and the rival pharmacy is a franchise of Trébol, a group of 52 establishments. Two large groups had maneuvered to keep the most succulent part of the business in Villa del Prado.

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The Trebol Pharmacy, in Villa del Prado, which has taken away the competition's clientele.
The Trebol Pharmacy, in Villa del Prado, which has taken away the competition’s clientele.DAVID EXPOSITO

This exclusive supply agreement seems for some reason to be a tricky issue that Sacyr Social wants to hide. A company spokeswoman denied to this newspaper by email that there is a contract, but the rival pharmacy admits its existence. Juan Pablo Aros, the lawyer for the pharmaceutical company, María Paz Borges, says that the home for the elderly centralized the supply of medicines “to facilitate management” and adds that this is a common agreement between pharmacies and residences.

A source who works in that nursing home and has full knowledge, as well as a relative of a resident confirm that there is an agreement. The employee of the nursing home, who requests anonymity, says that “the company chooses its medicine supplier, just as it chooses its meat supplier.” Workers at the residence refer to Trébol as “our pharmacy”. [Un secreto más oscuro de esta residencia fue desvelado esta semana por EL PAÍS: la Fiscalía investiga la muerte de una residente que salió sola en silla de ruedas y chocó contra un muro tras caer por una rampa].

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“We love you very much, but we fear reprisals”

In theory, Gil has the advantage of being closer to the residence than his competitor. Family members or residents can take a short walk from the residence and arrive at your door. But most of the 120 people who live in that nursing home are dependent and the residence is in charge of buying these medicines for them.

The center should inform residents and their families of the freedom they have to choose a pharmacy, as explained to Gil by the College of Pharmacists of Madrid. The Sacyr Social spokesperson assures that the company always obtains this option from users in writing, but this practice is denied by four relatives of residents, neighbors who request confidentiality. In this small town they don’t want to be singled out for taking part in the controversy. Three who had their relatives inside years ago affirm to this newspaper that they were never told anything and a fourth related to a current user assures that a center worker informed him of the possibility of choosing a pharmacy, but conditioned him by telling him that for them “ it is much more comfortable” to buy the medicine in Clover.

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Gil has talked to his former clients to find out why they don’t object. “They accept what the residence says because their parents are vulnerable people and they choose not to contradict them,” says Gil. “Your health and well-being is in your hands.”

A man in front of the Villa del Prado nursing home, publicly owned and managed by a large private company, Sacyr Social.
A man in front of the Villa del Prado nursing home, publicly owned and managed by a large private company, Sacyr Social.DAVID EXPOSITO

For almost 20 years, Gil has moved heaven and earth to defend his business, which he says has suffered serious financial damage. On the counter and on the door for some time he exhibited posters that he still keeps in a drawer and that read: “Do you have a relative in the Villa del Prado residence? This may interest you.” The document informed them that “they have the right to choose the pharmacy that provides the pharmaceutical service, not being limited only to the pharmacy that supplies the residence.”

It does not worth for anything. “No one came,” he says, “They told me: ‘We love you and your family very much, but we fear reprisals’ and it’s normal, imagine an elderly person sitting in a wheelchair and with a catheter. You can’t go against the management.”

In the last two years Gil has gone to the City Council, the Ministry and the Ombudsman. The answers that he is receiving tell him that if the right to choose a pharmacy is being violated, as Gil assures and the relatives confirm, it should be the residents themselves who present the complaint before these instances, since they would be the victims.

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Perhaps Gil would be more successful if he argued that his right to free competition is being violated. Consulted by this newspaper about the case, the College of Pharmacists of Madrid recognizes that exclusive supply agreements between pharmacies and residences exist. Sometimes these agreements include pharmacies far away from the nursing home. The president of the Association, Luis González Díez, has proposed to the Community of Madrid that in the upcoming reform of the Pharmacy Law the residence, regardless of its size or ownership, is obliged to contract equitably with the pharmacies of the municipality or the health area where it is located.

Other strange cases

Relations between residences and pharmacies are very opaque. The Community of Madrid does not make public the information on which residence buys from which pharmacy and how much, data that according to consulted pharmacists would be possible to know thanks to the fact that everything is computerized since the introduction of the electronic prescription.

Sometimes very strange cases have come to light of pharmacies that supplied residences located at a great distance, which suggests that there are agreements between the two to share the benefits. In 2002, the PSOE denounced in the Madrid Assembly that a public residence in the capital of Madrid had a supply agreement with Juan Gil’s competitor in Villa del Prado, 80 kilometers away. In other areas of Spain, striking cases have been known: in 2018, 10 of the 2,300 Valencian pharmacies shared 25% of medicines for private residences.

Gil is desperate because his billing has dropped a lot. In all this time, very few residents have bought from him: “Now I only have a 97-year-old woman who comes on foot and she is brave.”

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