The pharmacy retail market today looks like a chessboard where the rules changed halfway through the game. The old moves still work. The old pieces are still on the board. But the winner is no longer whoever plays better; it’s whoever is first to realise they need to play a different game.
The more forward-thinking shareholders and senior managers of the pharmacy chains can see this. That’s why we’re beginning a strategy project (we’re not permitted to disclose the client’s name).
Trends and countertrends: not a single obvious answer
- AI is arriving in the pharmacy. Algorithms for range planning, shelf layouts, an AI pharmacist online. But 67% of patients want their advice from a real person. Especially the first time they come in. Especially when they have doubts. The question: are we a technology pharmacy, or a pharmacy with technology? Those are different businesses.
- Telemedicine is ‘intercepting’ prescriptions. Ro, GoodRx, Helsi+ — a prescription in 10 minutes with no queue. But 71% of Ukrainian patients still go to the pharmacy first. Out of habit, trust and being close to hand. The question: are we the point of first contact, or a collection point? Those are opposite strategies.
- Smartphones are intercepting the choice. Searching, comparing, reading reviews — it all happens before a person ever reaches the shelf. But return rates in e-pharmacy run at 30–40%, against around 5% for bricks-and-mortar pharmacies. People still want to see, touch and ask questions. The question: do we offset the shift to smartphones, or integrate with it?
- Subscription models are ‘bypassing’ pharmacies. PillPack, Amazon Pharmacy — a monthly subscription with no trip to the pharmacy. But 40–50% of purchases are urgent: acute pain, colds and flu, allergies. You can’t put that on a subscription. The question: are we competing for patients with chronic needs, or winning in the acute-care segment?
- Private label and generics: why not become the manufacturer? At CVS, own-brand generics account for 40%, at Walgreens 35%, and Amazon Mainstay has already launched. But 55–60% of patients don’t trust generics without a familiar brand behind them. Brand matters. The question: are we building a pharmacy brand, or a brand of expertise?
- Tariffs and regionalisation. Customs tariffs stand at 17.8% — the highest since 1934. Imported generics are getting more expensive. At the same time, that’s an opening for local manufacturers. Farmak, Darnytsia and Yuria-Pharm need strong local channels. The big chains remain rigid. The question: are we ‘just another chain’, or a strategic partner to Ukrainian manufacturers and patients?
And then there are the quirks of the Ukrainian market that you won’t find in any textbook:
- There are twice as many pharmacies per head of population as in the EU. Ukraine has more than 18,000 pharmacies — roughly one for every 1,300 people, almost double the EU average. It’s one of the most saturated markets in Europe. In 2024 alone, the number of pharmacies grew by roughly another thousand outlets — despite a shrinking population. Competing for square metres has run its course. The question: do we open yet another pharmacy in a busy spot, or create a different kind of value?
- The regulatory pendulum is already poised to swing. Margins are being regulated all along the chain. The question: will we wait for new rules to ‘kill’ the business for us, or set the agenda ourselves, offering fresh value to manufacturers, patients and consumers, along with a new business model?
- Consolidation and aggregation through Tabletki.ua. The market is consolidating from two directions at once. On one side, the top five chains. On the other, the aggregator sitting between patient and pharmacy grows steadily stronger. Tabletki.ua controls around 80% of the price-aggregator market, and last year the service handled reservations for nearly 70% of all pharmacy-retail bookings in the country. Most importantly, the aggregator’s brand has become so strong that users often don’t even notice which chain they’re collecting their order from. All they care about is the price and how convenient the collection point is. And in January 2026, the AMCU cleared Kyivstar to acquire Tabletki.ua. Now the aggregator has a telecoms giant behind it, with the data, the app and the delivery potential to match. Anyone competing on price alone on the aggregator’s shelf becomes an interchangeable SKU — and can kiss their margin goodbye for good. The question: are we a line in someone else’s marketplace, a faceless price in someone else’s app, or our own channel for building relationships with patients, consumers and manufacturers? Or perhaps with all of them at once?
Why ‘business as usual’ is no longer an option
Profitability in service-led pharmacy retail is falling systemically the world over, whatever the format. This isn’t a management failure; it’s a consequence of the current market model. A purely retail model means slow erosion: over five years, margins slide to 2–3%. It’s not a disaster yet, but it is already drifting towards irrelevance.
Simply copying the competition isn’t the answer either. If a chain does exactly what ANC or Podorozhnyk does, it becomes little more than someone’s remix — with a fraction of the resources. And remixes don’t deliver premium returns.
That leaves a third path — answering the question of who a pharmacy chain wants to be in a world where the ‘classic pharmacy’ is no longer a business model with a future.
That’s why we do the strategy work together: from deep diagnostics to identifying focus arenas, new business models and opportunities to grow capitalisation. We’re betting on the idea of ‘the pharmacy as part of a wider infrastructure rather than its core’ — and we’re prepared to rethink even the shareholder strategy for this asset.
Let’s see what the results bring.