“A sin of omission”—this is how Dr. Zakariás El Koulali, Chief National Pharmacist and Director General of the National Center for Public Health and Pharmacy, described the fact that hundreds of thousands of deaths could be prevented each year, yet the healthcare system continues to neglect the full potential of pharmaceutical care. Undiagnosed but detectable conditions, improper medication use, and a mere 50% adherence rate are driving up pharmaceutical expenditures—while the system remains overwhelmed and prevention remains underutilized.
“We are in the eleventh hour,” Dr. El Koulali warned at the “Pharmacy 2030” conference, organized by the Association of Networked Pharmacies. He emphasized that now is the time for pharmacists to take on a truly proactive role in public health, particularly in early detection, chronic care management, and delivering personalized, digitally supported health services.
There are approximately 115 million pharmacist-patient encounters in Hungary each year—a massive, yet largely untapped opportunity. In a country where nearly 30,000 people die annually from cancer alone, and half of all avoidable health damage is medication-related, the stakes could not be higher. Across Europe, 200,000 people die each year due to inappropriate medication use, and 10% of elderly hospitalizations are directly linked to this issue.
Adherence is a major concern. In Hungary, 50% of patients do not follow their prescribed therapy, meaning billions in public and private healthcare spending go to waste. Polypharmacy is also a growing issue: 30–40% of people over 65 take at least five medications, while 6% are on ten or more, requiring serious therapeutic oversight. Moreover, 7.5 million boxes of antibiotics are dispensed annually in Hungary—at a cost of HUF 4.5 billion to the state, and the same again out-of-pocket.
The rise of resistant bacteria due to overuse of antibiotics could result in 330,000 deaths annually in Europe by 2050 if no action is taken. Meanwhile, millions live with undiagnosed diabetes, hypertension, obesity, or mental health issues—conditions that could be screened and flagged early by pharmacists.
But Dr. El Koulali also sees hope. A growing segment of the population is taking responsibility for their health, seeking advice, prevention, and self-management tools. Pharmacies—present in over 3,000 Hungarian municipalities—are ideally placed to deliver accessible, community-based health services, including personalized counseling.
Digital tools are also underused. The EESZT system, a uniquely Hungarian e-health platform, is a powerful resource still not being fully utilized—just like those 110 million annual pharmacist-patient interactions.
Patient Organizations: Strategic Allies in a New Health Paradigm
One of the most underappreciated assets in tackling Hungary’s healthcare challenges is the vast experience and knowledge of patient organizations. These groups, working side by side with patients for decades, understand their everyday realities better than most healthcare providers. They play a pivotal role in health literacy, prevention, and patient education, yet their expertise is rarely integrated into the formal care system.
At the conference, Tünde Koltai, President of the Hungarian Alliance of Patient Organizations (BEMOSZ), stressed that collaboration between patient groups and pharmacists is not only possible—it is essential. Organizations like SZÍVSN are ready to support pharmacists in areas such as public education, training, patient follow-up, and development of informational materials.
“It’s time to recognize that patients are not passive recipients of care—they are equal partners,” Koltai said. “Doctors, nurses, and pharmacists should all work alongside informed, empowered patients. But this requires access to reliable, comprehensible health information.”
Today, the internet is often the first source of health information—frequently misleading. Koltai highlighted that if patients received accurate, relevant knowledge directly from their pharmacists or healthcare providers, they would no longer need to rely on questionable online sources.
Alarmingly, only 30% of the Hungarian population has adequate health literacy; the remaining 70% have minimal or no understanding of their health status or treatments. This isn’t just a barrier to adherence—it’s a systemic vulnerability.
“Patient organizations can be key in addressing this gap,” Koltai emphasized. “We can significantly improve health literacy and help patients better understand their conditions and treatments. In many chronic cases, the patient or caregiver knows the most—our organizations simply bring all these voices together. That’s a powerful, collective knowledge base that should be utilized.”
She added that the partnership between pharmacists and patient organizations could greatly enhance not only prevention but also the long-term quality of care. Whether through education, self-management, or adherence support, collaboration is the future.
“The health system of tomorrow cannot afford to wait until patients are already in crisis. A well-informed, cooperative patient is the key to a sustainable system—and we are ready to help. All we ask is: let us be part of it.”
