R. Villano - SYNTHETIC STUDY Pharmaceutical reforms in Italy XIX-XXI century (Warsaw 2017)

43rd International Congress
for the History of the Pharmacy
Warsaw 12-15 September 2017
Warsaw 15 September 2017 - Royal University
- S Y N T H E T I C S T U D Y -

2
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Raimondo Villano (Italy) - Pharmaceutical reforms from the Unification of Italy beginning of the XXI century
43rd International Congress for the History of the Pharmacy (Warsaw 12-15 September 2017)

Raimondo Villano (Italy)
Pharmaceutical reforms from the
Unification of Italy beginning of the XXI century
43rd International Congress for the History of the Pharmacy

C R I S P I
43rd International Congress for the History of Pharmacy

G I O L I T T I
Raimondo Villano (Italie)
Rèformes du service pharmaceutique à partir de
l’Unification de l’Italie jusqu’au début du XXI siècle

G I O L I T T I

M A R I O T T I
Raimondo Villano (Italie)
Rèformes du service pharmaceutique à partir de
l’Unification de l’Italie jusqu’au début du XXI siècle

43rd International Congress for the History of the Pharmacy Warsaw 12-15 September 2017

In 1985 EEC Directives 432/85, 433/85 and
EEC 434/85 on intra-Community trade in
pharmacists provided that: (432/85, Article
1), citizens holding a Pharmacy Diploma
have access to in preparation, manufacture,
control of medicines, storage, storage and
distribution in wholesale and retail (the latter
only as a pharmacist) and in hospitals as
well as dissemination of information and
advice; (432/85, Article 3) by 1 October
1990 the submission of proposals for
specializations in Pharmacy, with particular
regard to the hospital pharmacy; the
confirmation of geographic distribution of
pharmacies (organic plant, distance
between pharmacies, etc.) and the
distribution monopoly of medicinal products
solely for the Member States;

(Article 2, paragraph 2 of Article 433/85)
states that Member States are not required
to give effect to the diplomas to create new
pharmacies to the public and, if a second
Member State has a competition for
examinations, the 1st State may maintain
competition; (432/85) the mutual recognition
of diplomas, certificates and certificates and
other measures to facilitate the effective
exercise of the right of establishment of a
pharmaceutical profession which, in general
terms, presupposes residence in the
territory of the host State.

17

In 4 February 2003 the Constitutional Court with judgment
27/2003 on timetables, shifts and holidays reiterates that
the regulatory system governing the pharmaceutical service
is aimed at guaranteeing constitutional right to health and
not protection for the pharmacists category and points out
that the introduction of uncontrolled competition such as
free time can reduce the level of collateral insured citizens;
it is also clear from the judgment that it is important to
ensure the survival of small pharmacies, particularly at risk
if an uncontrolled competitive system. On July 24 the
important 275 judgment of the Constitutional Court states
that the overlapping of the intermediate and final distribution
of the drug, in the case of the sale of municipal pharmacies
to intermediate distributors, results in a conflict of interests
potentially detrimental to the health of citizens.

In 2004, then, the European Commission on competition
calls for the elimination of rules that are considered too
restrictive in favor of other less "protec- tionalist";
Furthermore, in the process of the Bolkestein Services
Directive for competition in EU countries, the European
Parliament approves the exclusion from the provision of
health services, including the pharmaceutical: a substantial
legitimacy of the importance of pharmacy not in the free
market.
The European Commission to initiate an infringement
procedure against the Italian Government on
inheritance, incompatibility, proprietorship and
pharmacy company essentially asking for capital to be
admitted to the management of pharmacies and that their
property also belongs to non-pharmacists: the Italian
Ministry does not accept the evidence by considering any
measure in favor of the prevalence of mercantile aspects in
the injurious pharmaceutical system for the protection of
health and the quality of the system itself.
. Raimondo Villano (Italy)

In May 2005, Francesco Storace's Minister of Health, at
a difficult economic time for Italian families, with Decree
87 on pharmaceutical discounts on SOPs and OTCs
competing with pharmacies, creating tearing inequalities.
In fact, Pharmacy takes on an overturned connotation
and reaches the most urgent liberalism: the price of
medication, equal to all over the country, takes shape as
a good thing to bargain with the pharmacist.
They are therefore the prerequisites for creating
privileged pharmacies (big pharmacies), which have the
option of practicing more pharmacies against small,
family-run or rural pharmacies, with a prospect of
probable closure. Such a form of liberalism, in the name
of the "big fish eating small fish" also poses serious
assumptions for the disappearance of the concept of
organic plant(9).

Meanwhile, in Brussels, the European Commission, taking
care of normative incompatibility of pharmacies with the
Community Treaty (artt. 43 e 56: freedom of
establishment; free movement of capital), Italy refers to
the Court of Justice because the interpretation and
modification of national laws, implemented in April by the
Constitutional Court, did not abolish the conflict with the
Community rules on: prohibition of the acquisition of
holdings by companies that have the business of
distributing medicinal products (or linked to companies with
such activity) in private pharmaceutical companies or
municipal pharmacies; reserve of ownership of private
pharmacies only to pharmacists or only juridical persons
made up of pharmacists. .

On June 30th, amidst amazement, regret and concern of the Italian
Farmacist Order Federation, the Council of Ministers for Decree
approves the new rules on competition and consumer rights,
known as Bersani Package(10), which they establish(11): sale to the
public in drugstores and supermarkets of medicines not subject
to medical prescription during the business opening hours, in part
of the defined area and distinguished from other departments, with
the assistance of the pharmacist enrolled in the Order and forbidding
premium operations and undercutting; free drug discount, with a
price that is clearly legible and clear to the consumer and practiced
at all; abolition of the requirement for wholesalers to hold at
least 90% of specialty on the market did not allow Ssn refund;
possibility of pharmacist holding several pharmacies or
associated to handle multiple exercises, even beyond the
province of belonging (a genetic mutation of the pharmacist
which from self-employed professional-worker becomes
entrepreneur); eliminating the incompatibility between wholesale
and retail activities; overcoming the inherited principle repealing
the norm for the heir to continue for years without the degree.

S U P E R M A R K E T
On 12 August, three Ipercoops at Carpi, Ferrara and Bari open the corner of the counter medication
and a sign explains: “Customer loyalty should not be encouraged with indiscriminate consumption of
medicines”; the consumers appreciate the liberalization, with 8 out of 10 favorable; on August 15 the
market in the Coop is already 2% of turnover(12).
On July 19th the pharmacies react by adhering compact to the first strike after 37 years: 93% closed for
protest while Decree Bersani left the Budget Commission; on July 26 there is the second closing
“indefinitely” of 95% pharmacies with sit-in in Rome while the Decree is fired by the Senate with a vote of
confidence.
27

The pharmacy maintains centrality in the relationship with the drug; the monopoly,
therefore, is not cracking: life-saving and recipe drugs are left alone in the pharmacy.
Critics, however, point to a historic anomaly: a sort of 'hypo-pharmacist' in the
hypermarket, a minusvalent practice that can only sell one category of drugs and
which does not have the same effect in other nations; the most disturbing limit would
be in the light of the constitutional principles of of Frederick II of Swabia: the
economic security of a category does not preserve it from corruption and fall, but the
opposite is certain, that in the absence of sufficient income, the dishonesty is very
likely and so, the 'hypo-pharmacist' in persistent critical position would be at
risk of quackery for the necessity of survival(13).
29

30
But the "Bersani" brand liberalization siren also makes another slaughter of hearts (and
interests) among pharmacy owners who, in number, do not start to run para-pharmacy for
the sale of drugs by forcing the tops of Federfarma to stigmatize such behavior as
"politically inappropriate(14)”.
President Giorgio Siri and Secretary Franco Caprino from Federfarma declare the
Council of Presidency's absolute opposition to the opening of these new drug sales outlets
"to the detriment of the principles of the organic plant", the bark of the territorial
pharmaceutical service. Additionally, professional pride is aimed at preventing the
pharmacist from becoming a "mere drug entrepreneur" and inviting local associations to
ensure that pharmacies open by pharmacists do not become "tools for violating industry
standards", considering that : it is forbidden for the licensed pharmacist to engage in
activities in both exercises (violating the law "always in the pharmacy"); it is forbidden to
freely open branch offices or detention centers and, more seriously than possible criminal
offenses, there is a temptation for the pharmacy owner to incur "in collecting recipes for the
benefit and at the request of a pharmacy".

31
Furthermore, from a legal point of view, the destiny of the pharmacy system is understood
as "unicum profession / structure / service", as pronounced by the Court of Cassation (27
February 2003, no. 27), while from the metaguridic point of view it is not may exclude the
"possibility" that a para-pharmacy extramoenia owner may be tempted to either open an
extramarine drugstore and keep the para-pharmacy intramoenia open when the
pharmacy is closed, splitting the grotesque when it does not configure (ie!) a simple act of
competition for misuse of customers pursuant to Article 2598 of the Italian Civil Code, in
harmony with the 'pharmacy network', which guarantee the continuity of the pharmacy as a
public and social service (Constitutional Court, 27/2003), granted by the profession end in
an organized enterprise structure (Constitutional Court, 448/2006)(15).

32
At the end of 2006 there was a significant spread of internet surfing aimed at
gathering information about their own health and family and relatives or on counter
medicines. In Italy, the network is the first source of health information for over 20 million
Internet users: 78% (15.6 million) have been navigating over the past 12 months to seek
medical information on average for four different diseases(16).
On February 1, 2007 the Antitrust Authority submits to Parliament, the Council of
Ministers and Regions a Non-binding Reporting requesting legislative action on
'pharmaceutical exercises' to: eliminate the maximum daily or weekly opening hours, with
a faculty of openness beyond normalized schedules; eliminate the minimum annual leave
limit and the regional or municipal imposition of uniformity of opening hours; to avoid local
administrative decisions being conditioned by representative organs of pharmacists.
All this by claiming that the Bersani decree has a competitive disadvantage precisely at the
expense of pharmacies, forced to adopt opening hours, shifts, holidays, etc. more
constrained than the competitors of the gdo and, on the other hand, considering that the
ruling of the Constitutional Court 27/2003 passed, argues that the maximum opening time
limits are a danger for pharmacies unable to compete with commercial businesses of the
same constraints.

33
In May, the Productive Activities Committee of the House of Deputies approves an
amendment to eliminate fitness requirements for a pharmacy owner(17) but it rejects another 2
(lower quorum pharmacy / 3,000 inhabitants and independent of the population of the municipality;
sale of drugs and drugstores, with a distance> 250 m distance from neighboring pharmacy, also
medications subject to medical prescription of 'band C' ).
On 29 May, the House approved an amendment(18) of the 'Bersani-bis' which aims to
deregulate (the only case in Europe) the sale of medicines requiring medical prescription,
allowing it to be used in pharmacy. After approval to the House, the Ddl passes to the Senate
where the Government intends to speed up its takeover within a few months. Federfarma brings
together the Presidency permanently to analyze and discuss protest initiatives while its
members engage in ongoing meetings with political forces "to expose the adverse
consequences of the amendment(19)”.
President Giorgio Siri convenes an urgent call of the National Assembly on June 7, which is
being resigned by the Federfarma Directorate, and also invites the President of the Romano Prodi
Council, the Minister of Health Livia Turco, the Minister of Health Economic Development Pier Luigi
Bersani and the majority and opposition MPs for which Federfarma intends to ask for clear answers
on the future of the Italian pharmacy and the level of health protection they want to guarantee to
citizens-voters.

34
A Federfarma press release of May 31 stating that "it is unworthy of a civil and democratic country
that, while more than one tables of confrontation between government and industry operators (on
pharmaceutical expense, pharmaceutical service rank and pharmacy role), with a blow a majority
vote of the House approves an amendment that, if confirmed by the Senate, would demolish the
pharmaceutical service. The first sign that Federfarma expects is obviously the deletion of the
amendment, approved by the House".
Minister of Health Livia Turco declares that she will ask the Senate to correct the Chamber's
decision; Assofarm Municipal Pharmacies follow the events concerned; for the National Free
Movement Pharmacist, what matters is the pharmacist because "a guarantee for the health of
citizens is not the place where the drug delivery takes place, but who carries this action. It is
therefore irrelevant for the protection of public health if the pharmacist operates in a pharmacy or
other exercise"; the Federation Medical Orders Surgeons and Dentists is critical of leaving
Pharmacy C drugs out of the pharmacy but asks that it does not invade medical expertise
(President Amedeo Bianco says that for the Central Committee "proposals to Transform Pharmacy
into a Performance Structure first-level healthcare providers are likely to attribute inappropriate
professional roles to the pharmacist, harassing the citizen of false assurance and exposing the
professional to serious legal liability. The pharmacist is a ssn cardinal figure, it would endanger the
safety of citizens if he becomes an improvised physician or in a healthcare provider".

35
The Forza Italia parent company in Senate Hygiene and Health Committee Laura Bianconi is
preparing a counter-amendment to abolish the standard. On July 18, representatives of
Federfarma and F.O.F.I., presenting the paramedical organizations, are on hearing at the Senate
Industry Committee and argue that the "C-band" drugs from the traditional canal are averted. The
FOFI highlights that there are very delicate drugs (drug, doping, antipsychotic, antitumor, anabolic,
post-pills) in the C-band, whose dispensation in the pharmaceutical structure guarantees the safety
of citizens with a complex mechanism of controls and health authorities; that the abolition of
exclusive pharmaceuticals on these medicines (about 50% of annual turnover, to compensate for
expenditure charges) may lead to a gradual reduction of capillarity guaranteed in the territory, even
at night time; that if it is advantageous for pharmacists in rural or peripheral areas to open an
exercise in more attractive business areas, those areas would be free from pharmacies to harm the
citizens; conflicts with the pharmaceutical service: encouraging the opening of pharmacies and
corners of the Gdo, with prospects of more profits, blames the criteria of the organic plant, favoring
the proliferation of exercises without distance constraints (happened in Greece: in 1991 liberalized
but , an exponential increase in the number of exercises compromises the economic viability of
pharmacies and the government establishes the total blockage of new openings in 1997); which
evoke miraculous savings for consumers while "C-band" drugs are subject to fixed and unique prices
on the national territory.

36
Federfarma also highlights the risk of disrupting both the abolition of the fitness requirement or
the professional practice for the purchase of pharmacies (it makes possible the mini-pharmacy
chains owned by the sole proprietor pharmacist) and for the institution outside of any rule, of
"unconventional" pharmacies with Ssn, superimposed on the network of existing ones (a
decisive and irreversible step towards the wild deregulation of the system and the
discarding of rules to guarantee the capillarity of pharmacies on national territory).

On August 6, Autogrill announces the
opening of the 1st corner 'Sosta
Salute' on the motorway Rome-
Florence: a pilot point for the sale of
about 2,500 prescription-free drugs,
with pharmacists and the possibility of
performing basic diagnostic tests eg
pressure measurement) and have
directions on nearest pharmacies.
37

On September 5, the Council of Europe issues Resolution Res AP 2007/2 on
distribution of medicines for correspondence for protection of patient safety and quality
of distributed drugs. In Italy, distance selling (via the internet, correspondence, etc.) of
medicines is not regulated and can not be considered as permissible; Article. 34 of the new
deontological code of the pharmacist, as well as the old art. 25, makes an express
prohibition on selling on the internet. The Council of Europe recommends Member States
"to take all the necessary means to ensure the safety of the sale of correspondence, to
protect the safety of patients and the quality of distributed medicines".
38

We mainly focus on: distribution systems and responsibilities; information and advice to patients;
notification to / from the patient of undesirable effects, interactions, warnings, remarks, defects of the
medicines sold; prohibited sale of very delicate drugs; management of medical prescriptions. In
general, the document underlines the need for: not to free the sale of virtual pharmacies online from
the physical territories, for the need for a direct relationship "as far as patient advice is concerned";
that the virtual pharmacy has pharmacists, because "the sale of medication by correspondence
should only be carried out by legally authorized persons"; that the sale of prescription-only medicines
takes place under the responsibility of a pharmacist and after submission of a regular prescription
medical e-mail, with documented authenticity.
39

In June, the Italian government intervened adiuvandum in an international pharmacy
defense in the referral referral of the Principality of Asturias to the European Court of Justice,
for similar findings to those brought to Italy: compatibility between art. Article 43 of the EC
Treaty on freedom of establishment and measures for the organization of the pharmaceutical
service (proprietary reserve for pharmacists, organic plant and quorum forecasts, and Asturian
legislative peculiarity, advantage in competitions for professional experience accrued in the
Principality).
45

The Italian State Advocate General maintains that the questions put by the referring court are
inadmissible on the grounds that the contested rules are not explicitly stated, but are cited in
a general and confusing manner. However, in the case where the application was accepted,
Italy suggests to the Court to consider Art. 43 not hinder the possible discipline of
pharmaceutical activity as a public service, resulting in organic plant potentials and distances,
as the legislative choice to impose the opening of pharmacies with reference to specific
demographic indices shared by many Member States , is concerned with the need to ensure a
widespread presence of the service on the territory, although it is possible to derogate from
these indices for particular users' needs(23).
46

On 3 September in Luxembourg before the Court of Justice the first hearing of Case C-531/06,
initiated by the European Commission, against the Italian legislation permitting the possession of a
private pharmacy only to natural pharmacists at a pharmacy and to pharmacists only, held to be
contrary to the freedom of movement of capital and establishment enshrined in the European
Treaties; representing Italy's State Attorney Giuseppe Fiengo (27) harangue that: competence on
health issues is the Member States; the public interest is defended by the state and not by capital
companies; the protection of health is a specific indispensable purpose of the ownership reserve; the
important public function is conveyed to the independent pharmacist; the Italian legislation (in
accordance with Article 42 of the EC Treaty) is not discriminatory between EU citizens but adopted on
the general precautionary principle for the protection of the health of all citizens.
49

The Lawyer, recalling the due respect of the principle of subsidiarity, points out that the Italian
Government has opposed the imposition of a single European pharmaceutical service by the
European Commission for all Member States.
Representatives of France and Germany share the Italian arguments, the Spanish states that if
the Court's requests were accepted, it would assume a political role in replacing Parliament with
the gradual imposition of a single pharmaceutical service model to the various Member States,
falling within the spheres of competence and inevitably compromised in its own characteristics
as provided for by specific national regulations.
50

The hearing is also interesting to learn about the arguments of the 10 Member States (Austria,
Finland, France, Greece, Ireland, Italy, Latvia, Holland, Poland, Spain) participating in the two
cases in defense of national law: 8 in defense of Italian and German legislation, neutral Ireland
and Poland in defense of the Commission's thesis. Finally, the case is also interesting because
it details in detail the arguments of the European Commission in favor of a liberalization of the
pharmaceutical sector. On 16 December, the Attorney General of the European Court of
Justice Yves Bot will submit his findings made public on the Italian and German causes; in the
months following the submission of the findings, the Court shall rule by a judgment equally
made public.
51

So, close to the first decade of the new millennium, the
pharmacy, despite years of both the category and the
society, was more than the sentiment of a widespread desire
for liberalism and has no shortage of progressive loss of
professional dignity, seems to have almost come to one
last beach, in which he should duly reflect and assume both
the awareness of the absolute dependence of his future on
a collective conscience of the unprocrastinability of the
rediscovery of the role of the pharmacist what a sentinel
for the protection of public health both of the responsibility
of the behavior that would arise; of course, not ignoring the
structural rigidity of the pharmacy system, unable to adapt
to the needs of the community but with excessive
"elasticity" in the application of certain principles
inherent in the very concept of profession.
52

They are correct with efficiency some serious process long since degenerative and, to
the long, lethal: 1) the widespread self-referentiality which is present in the category
(in the belief that the caduceo on shirts is enough to be considered indispensable to the
community, to deserve the respect of others, to be sufficient to themselves and not to
need others) creating around a political and institutional vacuum that, if need be, in the
face of shared arguments, there is little agreement and very little willingness to support.
2) the excess of neglect “which, in the face of the traditional strengths ensured by the
legislation, was not too concerned about building its future, but was limited to discovering
what they were doing, without merely collecting what was coming. Until the days have
begun to bring surprises far from pleasing, beginning with the collapse of many of those
strengths that provided protection(28)”. 3) the poor cohesion speaking different
languages, sometimes opposite or dissonant or asoning but still different: the impression
of a unified profession and, in some circumstances, at least defined (even by ministerial
summaries) "badly represented". 4) deontological breaches by aggressive minorities
who too often dispose of service rendered to the citizen any more bickering form of unfair
competition(29).
53

An even more delicate aspect, then, is the endemic criminal phenomena that lick the
profession: A) some drug stores, more or less large but with a business round beyond
every medium and every imagination, in addition to operating only with aggressive
business methods, according to numerous judicial inquiries they are able to establish
compliant or fraudulent collusions, sometimes even with politicians, creating militant
commercial monstrosity that they spread a real moral disorder through the
establishment of muddy relationships with compliant doctors (from the rent of the
ambulance, sometimes even in the same pharmacy, much worse: compliant or false
prescriptions or various scams) and / or establishing a closed market where holders and
politicians barred licenses and prebends. Obviously, the honest and scrupulous
pharmacist who unfortunately it has to close one of these dishonest pharmacies or
adapts or emigrates or, reshaped in a short time, is sucked into a spiral where he comes
to feel sorrow for honesty. B) According to the alarm launched by some pharmacy
organizations, as well as investigative attention, there would be malevolent infiltration
in some companies either to place their own protected or familiar work or to control them
from the inside and, above all, to make huge economic profits and recycle dirty money: a
real bottomless bottom well.
54

Directly or indirectly, therefore, the profession inevitably finds itself in different circumstances to
deal with the public need to 'wash the mistakes and not just the face(30)’. In short, in the period
coinciding with approximately the last thirty years considered, the importance of the drug
(which is not only the result of the economic weight of public and private pharmaceutical
spending) has grown considerably (in terms of health, for the development of new molecules;
in economic terms, for the huge increase in public and private resources allocated; in social
terms, for the increasing attention of the population and the media for health and well-being)
but in proportion, the importance of the pharmacist has not increased, indeed, in the collective
imagination the role of the pharmacist has in some way even declined both because the
customization of the relationship replaced by trust in the brand has diminished, as well as by
the gradual expansion of merchandise, which is not infrequent in the pharmaceutical exercise,
both because of the exasperated exasperated commercial and marketing connotations
adopted by a growing number of pharmacies, both for non-rare black news events and
because the consumer has been gradually induced to believe (and has also been increasingly
believed) to be able to do unless the pharmacist. The situation also appears to be the result of
a significant imbalance stratified over time and, until a while ago, a Renaissance of the
profession seemed desirable, occurring find again, not find whereas, in the light of recent
changes, it is clear that the future has substantially placed its roots in the present.
55
43rd International Congress for the History of the Pharmacy - Warsaw 12-15 September 2017

Directly or indirectly, therefore, the profession inevitably finds itself in different circumstances to
deal with the public need to 'wash the mistakes and not just the face(30)’. In short, in the period
coinciding with approximately the last thirty years considered, the importance of the drug
(which is not only the result of the economic weight of public and private pharmaceutical
spending) has grown considerably (in terms of health, for the development of new molecules;
in economic terms, for the huge increase in public and private resources allocated; in social
terms, for the increasing attention of the population and the media for health and well-being)
but in proportion, the importance of the pharmacist has not increased, indeed, in the collective
imagination the role of the pharmacist has in some way even declined both because the
customization of the relationship replaced by trust in the brand has diminished, as well as by
the gradual expansion of merchandise, which is not infrequent in the pharmaceutical exercise,
both because of the exasperated exasperated commercial and marketing connotations
adopted by a growing number of pharmacies, both for non-rare black news events and
because the consumer has been gradually induced to believe (and has also been increasingly
believed) to be able to do unless the pharmacist. The situation also appears to be the result of
a significant imbalance stratified over time and, until a while ago, a Renaissance of the
profession seemed desirable, occurring find again, not find whereas, in the light of recent
changes, it is clear that the future has substantially placed its roots in the present.
56
43rd International Congress for the History of the Pharmacy - Warsaw 12-15 September 2017

In any case, the moments that seem to be wagering
are, instead, opportunities. The great goal, therefore,
that in this period seems to inevitably go to the
forefront of the Italian Pharmacy, is in fact, a crucial
new way of see things, who has the "serenity to
accept things that can not change, the courage to
change things that can change, the wisdom of
distinguishing one from the other” and be capable,
paraphrasing Adonis(31), to "transform tomorrow into
prey and to chase it to perish” gaining a break from his
unrepeatable past for the archetype of modern
pharmacy, indispensable to the affirmation of an ethical
identity that must precede the development of new
business strategies.
57

(1) Verucci Guido, La Chiesa cattolica in Italia dall’Unità a oggi.
(2) Ministry of Health, Website, 2006.
(3) D.L. September 13, 1946 of the Provisional Head of State Enrico De Nicola.
(4) D.L. August 4, 1947 of the Head of State Enrico De Nicola.
(5) Art. 46, R.D. 1706/38.
(6) T.A.R. Sardegna, 29.10.1982, n. 392.
(7) Il Giornale del Farmacista F.O.F.I., fourth year, n. 7 April 12, 1989, p. 5.
(8) State Council, Sez. IV, 23.10.1984, n. 217.
(9) Passalacqua Claudio, Risposta al Ministro della Salute, Atti e Memorie AD 2005, Noble College of
Pharmaceutical Chemistry Universitas Aromatariorum Urbis-Roman Academy of Pharmacy History and
Pharmaceutical Sciences; Cardoni, set 2006.
(10) Bersani Pierluigi, Minister of Economic Development.
(11) F.O.F.I., Farmacista 33 - Year 2, n. 119, July 1 2006.
(12) Sole 24 Ore, Economia e Imprese, August 2006, pp. 13, 17; The Morning, August 13 2006, p. 19.
(13) Garrisi Enrico, Professionisti ieri e oggi, Punto Effe year VIII, 4 - 8 March 2007, pp. 32-37.
(14) Circular Presidency Federfarma January 11, 2007.
(15) Nicoloso Bruno Riccardo, Il peggio che avanza, Legal background, Punto Effe.
(16) Survey on a network user's profile for information on her health presented in 2007 in Rome by Millward
Brown Elfo on behalf of Google Italy and the Edra medical and scientific publishing house.
58

(17) In practice, rules that made it possible to acquire the right to the pharmacy's title only after passing the
enrollment contest or after 2 years of certified professional practice.
(18) The rapporteur, Andrea Lulli (Ulivo), spoke favorably, while the Government had voted in favor of the House's
plenary vote, which approved 247 votes in favor, 201 against and 5 abstentions; contrary to the Centrodestra,
including liberal and liberal forces.
(19) Newsletter Federfarma 05/06/2007.
(20) The leading cooperative chain, with a turnover of 12 billion euros.
(21) Fofi National Council - Rome, June 19, 2008.
(22) Puato Alessandra, Coop, quanto è amara la medicina da banco, Corriere della Sera n. 20 of May 26, 2008.
(23) Source, Farmacista33.
(24) Newsletter Federfarma, July 16, 2008.
(25) A study exam started in the Senate on 17 September 2008.
(26) Parafarmacie: nubi e brividi-Ipotesi di lavoro: lista Aifa con pochi Otc senza farmacista al bancone, Il Sole 24
Ore Sanità - 2/8 September 2008.
(27) With the assistance of Attorney Antonella Anselmo, lawyer of the Federation of Italian Pharmacists' Orders.
(28) Leopardi Giacomo, Il futuro? Meglio crearlo che scoprirlo, Editoriale, Il Farmacista FOFI, April 13, 2007, p. 3.
(29) Abs and / or remodeling from: President of the Order of Pharmacists of Brindisi, Annual Assembly 2006.
(30) Constantinople, Baptistery of the Basilica of St. Sophia: "Wash the mistakes not only the face".
(31) Nickname of Lebanese Syrian Ali Ahmad Said Isbir.
59

R. Villano - SYNTHETIC STUDY Pharmaceutical reforms in Italy XIX-XXI century (Warsaw 2017)

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