Summary

• Estonia's government has approved draft legislation and referred it to parliament, allowing medicine-dispensing machines supervised by pharmacists over video.
• Pharmacy operators could maintain up to ten automated units, including in communities without conventional pharmacy premises.
• The provisions are intended to take effect on 1 March 2027 if adopted, with actual deployment depending on operators' readiness.

The Estonian government has approved legislation allowing medicines to be dispensed through remotely supervised pharmacy machines, opening a potential route to extended services in smaller communities without requiring a pharmacist to be physically present at every location.

The proposed amendments to the Medicinal Products Act were referred to the Riigikogu, Estonia’s parliament, on 5 November. They would permit customers to purchase prescription and non-prescription medicines through automated units connected to licensed pharmacies, with a pharmacist providing advice by video before authorising dispensing.

Each pharmacy operator would be allowed to maintain up to ten machines, either near existing premises or in locations where conventional services are difficult to access. The government intends the provisions to take effect on 1 March 2027, subject to parliamentary approval, although the arrival of the first operational units will depend on individual businesses deciding to install them.

The proposal has been developed with support from Accelerate Estonia, a government-backed innovation programme working with technology company Grab2Go and public authorities to address regulatory barriers to automated pharmacy services. Its progression to parliament creates a possible commercial route for the technology, but does not itself authorise immediate deployment.

Professional supervision remains mandatory

Under the proposed arrangement, a customer would select a medicine using an automated dispensing unit and communicate with a pharmacist through a video connection. The pharmacist would check the purchase, provide appropriate advice, and authorise release of the selected medicine.

For prescription medicines, the process would require identification of the customer and verification of the relevant prescription. Non-prescription purchases would not require the same identity verification, although a pharmacist would still review the selected products before completing the transaction.

This differs from a collection locker that simply releases medicine already prepared for a named patient. The proposed system incorporates a professional consultation into the transaction, allowing a customer to obtain advice remotely before medicine is dispensed.

The machines would remain part of the licensed pharmacy network rather than creating a separate class of retailer operating outside conventional professional supervision. Pharmacy operators would retain responsibility for meeting the requirements applying to medicine supply, including appropriate storage and dispensing arrangements.

Although the technology could make medicines available outside normal opening hours, a machine’s physical accessibility does not guarantee that every transaction can be completed at any time. An authorised pharmacist must remain available to carry out the required consultation and approve the purchase.

Rural access shapes the proposal

The government wants to improve access in communities where the number of potential customers does not support conventional pharmacy premises or extended staffing hours. Establishing an automated unit could provide another option without requiring a pharmacist to remain on site throughout its operation.

The model may also allow professional expertise to be shared across several locations, particularly where consultation demand is intermittent. Its effectiveness will depend on how many customers require assistance, the time each consultation takes, and whether remote staff can provide an appropriate standard of service.

Accelerate Estonia has identified the age profile of the pharmacy workforce as another reason for examining alternative delivery arrangements. The programme states that 53% of Estonia’s pharmacists are over 50, suggesting that recruitment and workforce planning could become increasingly important as experienced staff retire.

Remote consultation does not remove the need for qualified professionals, however, and any efficiency gains will depend on how pharmacists divide their time between dispensing, counselling, and their existing responsibilities. The technology could alter the distribution of work without substantially reducing the professional effort involved in some transactions.

Patients will also need an interface they can use confidently. Identity verification, prescription checking, video communication, and instructions for collecting medicine must function reliably, particularly for customers with limited experience of digital services.

Technical failures introduce further operational requirements. Pharmacy operators will need procedures for unavailable consultations, interrupted connections, dispensing errors, and equipment maintenance, alongside controls governing medicine storage and the handling of personal information.

Specialist preparation could be shared

The draft legislation also addresses medicines that must be prepared individually rather than supplied as standard manufactured products. Such work can require specialist facilities and qualified personnel, making it difficult for every pharmacy to maintain the same capabilities.

Under the proposed changes, a pharmacy could arrange for another authorised pharmacy to prepare medicines on its behalf. Patients would be able to order the required product through their usual pharmacy and collect it there or through an appropriate automated unit.

Limited arrangements involving hospital pharmacies are also proposed, allowing them to prepare or divide medicines for certain other pharmacies and healthcare providers. The changes would not provide hospital pharmacies with unrestricted retail or wholesale trading rights.

Shared preparation could reduce duplication of specialised equipment and make particular medicines available through more collection points. Its practical value will depend on transport arrangements, preparation times, quality controls, and coordination between participating pharmacies.

These provisions broaden the reform beyond the automation of individual transactions. They address how pharmacies organise specialist work and distribute services across locations with different patient demand.

Commercial deployment still requires investment

Estonian technology company Grab2Go has been developing an automated pharmacy model through Accelerate Estonia. Its participation reflects the programme’s approach to working with businesses and regulators on technologies that existing legislation does not readily accommodate.

Parliamentary approval would remove an important legal barrier, but it would not guarantee commercial demand. Pharmacy operators must still assess installation costs, maintenance, staffing arrangements, suitable locations, and the potential volume of transactions.

Manufacturers and technology suppliers would also need to demonstrate that equipment can operate reliably within the applicable pharmaceutical and information security requirements. A successful demonstration of a dispensing mechanism is not equivalent to proving that a distributed service can operate safely over extended periods.

For other European health systems, the Estonian proposal offers an example of how remote professional supervision could be incorporated into pharmacy regulation. Adoption elsewhere would depend on national medicine laws, licensing requirements, patient safety rules, and the organisation of existing pharmacy services.

The immediate decision rests with Estonia’s parliament. If the amendments become law, pharmacy businesses will determine how quickly the permitted model reaches patients, with the government targeting March 2027 for the relevant provisions to take effect.