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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 44: December 2005
Welcome to the December 2005 edition of i2P E-Magazine.
It's hard to believe that Christmas is almost upon us, when most of us have a feeling that we have not caught up with the early part of this year, seemingly disappeared and now behind us.
Of course, the period of suspended animation caused by the Fourth Agreement hassles saw a lot of activity and investment put on hold until it was signed.
Even now, many subsidiary agreements have to be ratified to allow funding to flow, and suddenly we have lost half of the new financial year.
It will take months to fully unravel the details to see what has truly been inflicted on pharmacy - so far it does not augur well.
There must have been an enormous government bureacratic effort to create so many future traps - no wonder they were late getting to the bargaining table.
Letters to the Editor - A Reader's Perspective
Letters to the Editor are encouraged to be submitted to this column, be they commentary on pharmacy at large or criticism and commentary of the authors and their articles.
Your name and contact details are required for publication, but they will be suppressed if requested.
Commentary relating to the global links section is also welcomed.
This month we have a letter from Andrew Roberts in response to a recent article on "Dosettes"and dose administration aids (DAA's) and another from Meredith Waddell, commenting on an article relating to corporate pharmacy models.
Global Health News from the Internet - Pharmacy Related Links
This section of i2P aims to keep readers informed of global news that may affect pharmacy.
Readers are encouraged to share links to items of interest, by simply e-mailing the story link to the editor located at firstname.lastname@example.org
Topics can range from drug-related news, Information Technology, medical communications, medical research breakthroughs, management and marketing issues.
Because this news area is dynamic and changes daily, readers should immediately bookmark any links that they find interesting.
Response to any item is also encouraged through the "Letters (Your Say) " column.
Rollo Manning - A Regular Column Reporting the News Behind the News
* The 4th Agreement – was the battle with Woolworths worth it?
* “Belting” for PBS dispensaries
* Location rule change the way to go
Neil Johnston - Management Consultant Perspective
With a universal shortage of health professionals predicted over the next five to seven years, governments around Australia are considering what strategies will need to be implemented to head off a major crisis.
Thinking to date evolves around the multi-skilling of all health professionals.
Nurses seem to have grasped the initiative here and have won limited prescribing rights through the development of clinical nurse practitioners.
In the US we have seen the growth of 15 minute clinics located in high consumer traffic areas such as supermarkets, utililising specialist nurses to deliver a range of health services that roughly parallel what Australian pharmacists deliver, but with the added benefit of being able to write prescriptions for S4 equivalent drugs.
In the UK we are seeing a different model evolve through "qualified Extended Formulary nurse prescribers" and "pharmacist independent prescribers" allowing the prescribing of any licensed medicine for any medical condition, with the exception of controlled (S8) drugs.
For the last article of 2005 I am taking a quick look at the global and local situation for pharmacy and what might be logical and reasonable pathways for pharmacists to consider over the next five crucial years.
Con Berbatis - A Pharmacy Researcher Perspective
Editor : The USA which has no pharmacist –controlled class of drugs was reported in November 2005 to have far fewer legally classified nonprescription (OTC) ingredients. The high and rising occurrence of misuse and adverse population effects of OTC agents across the USA seem more difficult to detect and control in the USA compared to countries with a pharmacist –controlled class of drugs.
In his next report Con Berbatis will explore the economic and population health benefits reported internationally and the possibility that countries with more effective OTCs for use in primary and self care may have lower national health care costs.
Neil Retallick - A Friendly Society Perspective
The Fourth Community Pharmacy Agreement has at last been agreed between the Federal Government and the Pharmacy Guild, only two of the stakeholders that will be impacted by the deals contained therein.
Whilst there is much detail yet to be finalized and many assumptions that must be made to allow its implications to be assessed at this point, it would seem in the broad brush to be likely to provide a very good result for pharmacist/owners, a very good result for the Big Three wholesalers, a poor result for the Government, a poor result for suppliers and a weak outcome for Australian taxpayers.
As with most contractual agreements, the devil will be in the detail.
Robert Forsythe - Globetrotting Community Pharmacist Perspective
The fourth community pharmacy agreement (Full Text) has not set aside any immediate monies for the provision of dose administration aids to nursing home residents – rather a review is promised within the first year of the agreement. Pharmacists working with aged care facilities will be well aware of the following problem. This review is long overdue – however it would seem that serious funding will not be likely this agreement as a budget is not mentioned.
Chris Wright - Dispensary Systems Perspective
Interesting choice of words for a topic I guess, but I refer to the future of the august industry that we participate in.
If we assume that the time honoured tradition of protectionism afforded Pharmacy for decades will come to a crashing halt next time around, and the fear of having to compete with Roger and his mates becomes a reality, will we say, in five years time, what if ?
That is, what if we had done it better and avoided what may not have necessarily been inevitable?
Annona Pearse - From a media perspective
As Pharmacists would be well aware there was a deluge of media attention given to the pre-agreement discussions involving, at various times and with various intensity, the Federal Government, the Pharmacy Guild, the Pharmaceutical Society and the management of Woolworths.
The tabloids, the broadsheets, television and talk-back radio were full of the contrasting positions of the combatants and, during many of the debates, the Pharmacy argument was not always expressed successfully or succinctly.
Chris Arblaster, PhD - A Consumer Self-Care Perspective
One of the most significant aspects of the Guild/Government agreement is the significant reduction in wholesaler margins on PBS products.
The three full-line wholesalers have not formerly announced their intentions in terms of how they will adjust their distribution business to maintain or improve their slim returns on investment from wholesaling in light of this change.
Anthony Tassone - A Pharmacy Manager Perspective
For what seems an eternity, the Pharmacy Guild of Australia has been engaged in tumultuous negotiations with the Federal Government over pharmacy remuneration and funding for the Pharmaceutical Benefits Scheme (PBS) in the next five years.
Finally, an agreement has been struck to the relief of many pharmacists, sales assistants (and no doubt bureaucrats).
Thankfully, pharmacies will remain out of supermarkets for the next five years, and the margin reductions for dispensing were perhaps not as significant as previously anticipated.
The dispensing fee increase of $4.75 to $5.15 partially offsets the discontinuation of remuneration for Medicare card collection and Consumer Medical Information (CMI) leaflet distribution, and the introduction of a flat dispensing fee of $40 for dispensed items over $1000.
Pat Gallagher - An IT Consultant Perspective
The editorial adviser for this publication often suggests topics that will be of interest to you, the reader.
Previously I have had plenty of my own ideas swirling around and therefore did my thing; today I am taking guidance from his editorial suggestion, which is:
“IT systems will also begin to explode and will be the driver of major change.
With the growth and accumulation of sensitive health data online, we will see hacking attempts to steal or corrupt data, and an increase in privacy prosecutions as weak security systems are uncovered.”
Fourty odd words that deserve dissection as they do outline the contemporary scene very well. Lets do bits and pieces in the triangular plot of community pharmacy, GPs and hospitals.
Who in turn sit inside another triangle of: governors, enablers and most importantly, patients.
Steven Brown - An IT Security Perspective
EDITOR'S NOTE: There is no such thing as a fully secure system, because in the final analysis, security comes down to the human factor, which is always a question mark.
Information may be sent and received in an encrypted and secure format, but of what use is that if a "human" decrypts the information, prints to a hard copy and leaves it exposed on a desk for all to see?
Steven Brown, our resident security consultant, discusses some of the "holes" that exist in software and systems, to compound the human factor in many online ordering systems.
Terry Irvine - Community Pharmacist Perspective
One of the joys of being old, and having been impressed by the usefulness of computers for a long time is the eagerness to embrace new technology.
Therefore when PBS On-line seemed to become universally available I was anxious to adopt the process.
For about six weeks now we have been able to see if a prescription has been paid, or more correctly will be paid, and if it has been rejected why.
Ken Stafford - A Consultant Pharmacist Perspective
Another year nearly over (where did the last six months go to?), time to again review pharmacy's progress.
What a depressing activity that has been as things do not seem to have improved in the past twelve months.
The issues that were high on the "worry list" at the end of 2004 are still present.
We have only recently seen the signing (finally) of the latest Pharmacy Agreement, giving some "stability" to the profession in the near future although I have my doubts about this.
Paul O'Neill - The Latest from the Pharmaceutical Society of Australia
Keep in touch with activities of the Pharmaceutical Society of Australia and their professional support for Australian pharmacists.
* 2005 PSA Pharmacist of the Year Announced
* Society Honours Young Tasmanian Pharmacist
Top Pharmacy Student Announced