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Issue 33: December 2004



Welcome to the December 2004 edition of i2P e-magazine, the last edition to be published for this year. In 2005 we start again in February, making full use of the extended holiday breaks to tidy up on housekeeping, also to take time out to plan improvements for our publication. The year has been an eventful one with Woolworths endeavouring to invade pharmacy, and other industry players such as Priceline and Mayne looking to position themselves more favourably in the general scheme of things. Perhaps the highlight of the year has been the Victorian decision to allow corporate pharmacies.

VICTORIA-Not Just a Pretty Face

November 10, 2004 marked an auspicious occasion when the Victorian Parliament passed a new Pharmacy Act. While most of the changes were expected, one seemingly small change has propelled Victorian Pharmacy to the forefront, and will now result in that state leading a revolution in how community pharmacy will best realise its potential. That small change was one to allow pharmacists to incorporate their businesses.


* Abandon PBS in favor of what? * Health professionals take stand on ability * The future of electronic messaging of health information * Pharmacist prescribing - who wants it? * Quality Use of Medicine - a job for all * Shortage of pharmacists - rubbish!

Vioxx and Other Drug Hazards Challenge FDA, ADEC and ADRAC

Editor : The commercial,  legal and population health damages associated with Vioxx (rofecoxib) are growing into the biggest furore in drug safety since thalidomide  (C Berbatis i2P November 2004) . The calamity facing Merck and the non-generics pharmaceutical industry has now engulfed the  USA ‘s drug regulator , the Food and Drug Administration (FDA). The medical and lay press in Australia has thus far skirted the implications for Australia’s principal therapeutics evaluation and safety agencies  ADEC (Australian Drug Evaluation Committee) and ADRAC (Adverse Drug Reactions Advisory Committee).

Pharmacy and the Necessary Evil

At a Pharmacy Conference held in Sydney earlier this year, there was some discussion about the retail, front-of-shop segment of a typical pharmacy business. The discussion centred around the fact that the average pharmacist is ill-equipped to run a retail business. As a trained healthcare professional, the pharmacist is, at any time of the day, focused on many things other than the price of a bottle of moisturizer, the rostering of the weekend casuals or the model stock holding for his bottles of Vitamin C. Today's pharmacist spends four years at University learning many things, none of which are related to operating a retail business in a cost-effective way that optimizes consumers' satisfaction.

Decision Time

If Mr Hooper, outgoing president of the PSA is to be believed the profession must change, and quickly, or forces external to our profession may change it beyond all recognition. While there is little we in the pharmacy profession can expect to do to influence the free trade agreement (FTA) with the United States, there are brave decisions that we can take to ensure that we never see the pathetic example of a pharmacy Mr Hooper describes from New Orleans.

Quotable Differences Ė the PSA & the PGA

A brief survey of the media over the last month reveals that the contentious issue of ownership still dominates the mainstream press and television, although the debate has certainly tapered off as an item of interest. As previously noted in this column, the Pharmacy Guild is represented in the media as the "voice of pharmacists", resulting in the profile of the Guild as considerably higher than that of the Pharmaceutical Society of Australia (PSA).

Governors, Enablers and a Landing in France

Apathetic about all this e.health hullabaloo? Ho hum, lets not worry then. Perhaps, for the moment life is too important to be distracted by it all. This is a serious observation and not merely a cynical happy-snappy headline to get attention; but now you are reading this, I might as well keep going, eh? Try as I may, it is not possible to just concentrate on e.health enabling ICT issues that are confined to inside the box of day-to-day community pharmacy issues. There is only so much I can repeat without making you and me brain dead, in covering just the usual subjects. POS, EFTpos, dispensary systems, wholesaler links, unique product identifiers and barcodes (or the emerging RFID tags), e.scripts, claims processing, staff training, smart cards and customer/patient technology impact issues, does becomes repetitive.

Using VPNs for Health Communication is a Bad Idea

Bruce Schneier is an acknowledged global expert on encryption and security having worked extensively with the National Security Agency in the U.S. In his book, "Secrets & Lies", he describes: "There's a story of a married couple in Silicon Valley who occasionally worked from home. He was checking his email while his wife was doing some programming, both of them on their small home network. Suddenly, his company's computers started showing up on her company's network and vice versa." A "hole" had suddenly appeared in a system thought to be totally secure.

May You Live in Interesting Times

2004 is rapidly drawing to a close with this being my final column for the year. Looking back over the year it is truly possible to claim that "pharmacy lives in interesting times" to misquote an old curse. Pharmacy has been through the mill this year but "what else is new?" with threats from large companies such as Coles or Woolworths, nurse practitioners and now doctors wanting dispensing rights. It appears that the only way to end the continual health tribes disputes is to amalgamate all the degrees into one, thus getting rid of the concept of doctors, nurses, pharmacists etc. This seems to be the one sure way to prevent the turf battles as everyone could do everything.

Restrictions on Solving Workforce Problems

The Queensland Pharmacy Act has been under review for so long that its long awaited tabling in parliament was a bit of an anticlimax. The Pharmacy Guild of Australia are not at all pleased with the latest recommendations in the Act and a lot of energy is being put into persuading ministers and their staff that the Act is not satisfactory. While I will never be an advocate for the ownership of pharmacies by the big retail giants, I do have a desire for alternate modelling to the current system of only pharmacists owning pharmacies.

New Advertising Arrangements for Therapeutic Goods

The Trans Tasman Therapeutic Products Advertising Code The Interim Advertising Council established to develop a trans Tasman advertising system for application in both Australia and New Zealand under a Joint Regulatory Agency, has held its last meeting and signed off on a proposed Therapeutic Products Advertising Code, expected to come into effect early next year following Ministerial endorsement. Development of this Code and the administrative arrangements has been a challenge, with stakeholders from both sides of the Tasman trying to come to a consensus on advertising requirements that will apply to a wide range of therapeutic products from a band-aid to a prescription drug.

Positioning for a Consumer Driven Market

It is well documented that the vast majority community pharmacies are relying more and more upon income from dispensing prescriptions. This has come about for a variety of reasons including, amongst other things, increasing prescription rates of higher priced medicines, the increasing number of specialist retailers competing with pharmacy in the beauty and other categories, and a trend of consumers to seek convenience at supermarkets. This is despite marketers of self-medication products increasing their advertising and promotion of scheduled self-medication products in mainstream media.

Coffee Breaks: Small Request Ė Big Implications!

One of the best attended and entertaining sessions at the recent PAC conference in Adelaide was the wind up during which a GP gave his views on HMR and pharmacy from where he stood. Apart from being highly entertaining it touched the funny and sensitive nerve in many pharmacists present when he commiserated on the dilemma he experienced when he suggested that the most practical and relatively enjoyable way of sharing a report on the HMR would be to have a coffee together. Small request - big implications!

Canít we all just get along?

One has always felt that there has been some tension between the Pharmacy Guild and the Pharmaceutical Society. The PSA, representing all pharmacists seems to have concerns that the Guild/Government agreements are not the Society/Government agreements, while the Pharmacy Guild rightfully questioning why the PSA should be involved in the negotiations that have been set up by the Guild, representing pharmacy owners. Common sense suggests that as representatives of all pharmacists, the Pharmaceutical Society should be the ones negotiating with the government on matters of tertiary funding and Continuing Education, while the Pharmacy Guild, representing business owners, should be negotiating dispensing fees, rural and remote allowances and pharmacy relocation. Sounds easy enough?

PHOTOKINA September 2004

PHOTOKINA is recognised as the world's largest photographic trade exhibition. It takes place in Cologne, Germany every two years at one of the largest trade fair venues in the world. The event is open to virtually everyone in photographic and ancillary industries and even includes audio these days. This includes professional photographers and advanced amateur photographers. The PMA show in the USA is the world's largest annual trade exhibition and convention but is presented for the photographic (and digital) trade industries only and will take place in Orlando Florida 20-23rd February 2005. There should be many new releases there as well. Both of these events are noted as being the major worldwide occasions when new products are launched.

Old Issues - New Approaches

Many Pharmacists around Australia have had the opportunity to meet recently with Michael Tachell and Bill Scott, following a Pharmacy Guild initiative. Our opinions regarding the NHS and the HIC were sought to provide constructive criticism on how the NHS might better serve the Australian citizen.

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