Over the past 4 years the pharmacy market in Sweden has been overhauled. What used to be a state monopoly has turned into one of the most liberal pharmacy market situations in Europe. The aim of this article is to give a brief overview of how this happened and what the situation is like today, with a focus on hospital pharmacy. I will also provide some comments on the current trends in Swedish hospital pharmacy.

In 1971 all pharmacies in Sweden were expropriated by law and amalgamated into one national pharmacy corporation owned by the state (Apoteksbolaget, later Apoteket AB). Apoteket AB's monopoly to sell pharmaceutical drugs to the general public remained until 2009. The hospital pharmacy market was legally never a monopoly,1 but in reality, Apoteket AB also ran all hospital pharmacies on a contract basis as there was no serious competition. In the general election of 2006 the Social Democratic Party lost power to a right wing coalition of four parties. One item on their political agenda was to break up the pharmacy monopoly. This was partly driven by the ideological belief that free market competition in general will provide improved availability and reduced prices, but also by EU pressure to dismantle state monopolies. The government appointed an inquiry in December 2006 to outline a liberalised pharmacy market in Sweden.2 The resulting official report formed the basis for the drastic legislative changes that followed, referred to as the re-regulation in this article.3,–,5

The re-regulation of the Swedish pharmacy market had three parts, all of which were implemented in parallel:

1. Changing hospital pharmacy regulation to provide flexibility for caregivers to organise their drug supply as they see fit.3

2. The creation of an open market for community pharmacies by breaking up Apoteket …