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- Issue 81: April 2009
- Issue 80: March 2009
- Issue 79: February 2009
- Issue 78: December 2008
- Issue 77: November 2008
- Issue 76: October 2008
- Issue 75: September 2008
- Issue 74: August 2008
- Issue 73: July 2008
- Issue 72: June 2008

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Issue 47: April 2006



Welcome to the April edition of i2P. As we were preparing to transmit, we were suddenly overtaken by the news that Coles Myer had purchased Pharmacy Direct, an Internet/mail order pharmacy owned by pharmacist Peter Brown. How could this be when the PGA had just bargained away a substantial component of community pharmacy PBS profit base, in exchange for pharmacist ownership of pharmacies? This announcement followed closely on the heels of Nicotine Replacement products being forced by government, into supermarket environments, supposedly to align with Trans-Tasman Harmonisation. Major shockwaves indeed!

Pharmacy News

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 neilj@computachem.com.au 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.

PSA News

Keep in touch with activities of the Pharmaceutical Society of Australia and their professional support for Australian pharmacists. This month: * New education resource supports pharmacists in their role in Osteoporosis * PAC for the Tropics * Pharmacists Give Thumbs Up To PSA's CPD Services

Events of Significance

As part of our information service, i2P will begin to inform on Conferences, Workshops and Seminars that may be of interest to pharmacists. PSA information will continue to be published separately in the section reserved for PSA press releases. Pharmacy organisations may submit material for publication, preferably in digital format (Word document). This month: * The Photo Marketing Association Annual Convention, to be held at the Sydney Convention Centre on the 30th April 2006. Speakers to inform on digital imaging and the marketplace, plus trade displays forall that's new and interesting in the digital world   * The Friendly Societies Pharmacy 2006 Pharmacy Management Conference. This conference is organised by the Friendly Societies and features people associated with National Pharmacies, one of the most efficient and professional pharmacy operators in Australia. Friendly Societies are a genuine alternative model of pharmacy, and have been around virtually since the First Fleet. The conference is open to all, and if the last conference is any indication, the hospitality is friendly and the content is topical and first-rate, and you will recognise many Pharma industry faces in attendance. Mark your diary now !


WHO LET THIS HAPPEN? NEWS OF THE DAY – SATURDAY 1st April 2006 TELL ME IT IS AN APRIL FOOLS DAY JOKE- PLEASE Just as this column was being finalized the news broke that a “grand fathered corporately owned pharmacy” in Sydney has been sold to Coles Myer. The Australian newspaper – also reported in Sydney Morning Herald, The Age and the Financial Review

There is no Fourth Agreement

When is an agreement not an agreement? Simple: when one party refuses to honour both the spirit and the substance of the agreement, when duress was used to coerce a signature to the agreement, or a patently unfair agreement has resulted. The government used pharmacist exclusive ownership of pharmacies to force its way, during the preparation of the Fourth Agreement. Even that promise has collapsed with the Coles purchase of Pharmacy Direct! Government will not need to worry about this for the Fifth Agreement - there will not be one. Open ownership is on the agenda and this will see a relaxation of location rules that will return pharmacy to a highly competitive, deregulated and destructive marketplace. It also means the end of planned and structured health delivery services through pharmacy. Many pharmacists will not survive in their current format, particularly after five years of Fourth Agreement attacks on pharmacy profitability.

Pharmacy Wholesaling – An Imperfect Market Becoming Less Perfect

The imminent introduction of the CSO payment scheme for pharmacy wholesalers will entrench existing cost inefficiencies and increase the overall cost of the PBS in the long term. The existing oligopolistic market will become less price-competitive. An oligopoly is the term used to define a marketplace where there are few sellers for a product or service - (One quantum measure is the market share of the four biggest players. In the pharmacy wholesaling market in Australia, the Big 3 have more than the 75% market share typically used to define an oligopoly).

Somebody Sue Us!

"Pharmacy's reprofessionalization will be completed only when all pharmacists accept their social mandate to ensure the safe and effective drug therapy of the individual patient" 1 In the early 1990's the world of pharmacy seemed to be buzzing with the prospect of making a difference to patients - and being paid for it! It has now been over 15 years. Have we accepted that we have a social mandate or has anyone else for that matter? According to the PGA we have the "best pharmacies in the world" so therefore we must have.

Why Isn’t "IT" Happening?

I have spent more time over the past four months in foreign climes, than here in Oz,  helping ‘governors’ set up e.health exchange platforms and standards. Each time I get back here it seems in the transition of health processes onto the Internet, or online, the world is spinning slowly, going no where. Perhaps that’s a good thing. Less haste, more speed, sort of approach. But, that’s not ‘it’, as I see it.

Even Pharmacists…?

"Workers will soon be able to have their medical certificates signed by health professionals such as ... and even pharmacist" was the report in the press recently. What does this say about the media's perception of pharmacy when it is surprised that pharmacists should be authorised to sign these certificates? For many years pharmacy appears to have deluded itself that it is seen to be a health care profession when newspaper columnists, who shape popular perceptions, raise questions about the appropriateness of pharmacists to decide if someone is too ill to go to work!

Patient Compliance - New Approaches

It is often stated that it could "only happen in America", but what becomes the norm in America often successfully transplants itself within Australia. A new initiative by US drug companies titled the "Take-Your-Medicine-Program" has begun in a response to a dramatic downturn in drug company sales. Lending credence to such efforts are many studies showing that failure to take medicines as prescribed, can cause patients to develop more serious and costly complications later. So with increasing regulation of marketing to medical practitioners, it may be seen that encouraging people to take their medication is a less controversial way to increase sales, and one that the industry says is in the best interests of patients and insurers. The health professionals being paid by drug companies to create patient compliance are nurses, who communicate often on a weekly cycle, by telephone or by personal visit.

1. The NRT Supplement - Editor's Introduction

This month we have set aside a substantial amount of space devoted to the NRT debate. It is clear that pharmacists were caught unprepared for this issue, and that it is only just starting to sink in that this decision has ramifications for the whole of professional pharmacy, running right down to 2010, the end of the 4CPA. For pharmacy, it is not just a distribution issue, it is a crossroad where major decisions have to be made about the entire pricing and service structure of pharmacy. No longer can pharmacy avoid charging a fee for its professional services. It has to be done - or you die!

2. Your Say - A Subscriber's NRT Comments

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 Roy Finnigan in response to a recent opinion piece in "Pharma-Goss"written by Rollo Manning. It should be read in conjunction with all other articles in the NRT supplement.

3. You Have to be in it toQuit it

The recent decision by GlaxoSmithKline (GSK) to distribute their Nicabate® Nicotine Replacement Therapy (NRT) products into supermarkets and petrol stations as of April 2006 has sent shock waves throughout the pharmacy profession. Although NRT lozenges, gum and patches have been unscheduled for some time now, none of the three major manufacturers: GSK, Pfizer or Alphapharm have ventured outside the pharmacy supply channel. until now. The pharmacy profession and namely the Pharmacy Guild have voiced their extreme concerns over the move citing that NRT sales from general retailers will not have any professional support or advice with the product sales, and furthermore these same retailers are profiteering from the very cause of the problem - cigarette sales.

4. Product Evolution and Switch

The issues of switch between schedules have recently been highlighted by the announcement by GlaxoSmithKline Consumer Healthcare that it will make its nicotine replacement therapy (NRT) product (Nicabate) more widely available by placing it in non-pharmacy channels such as supermarkets and convenience stores. Retail pharmacy understandably feels disenfranchised when it sees products in a significant category move to an open seller. What appears to be lost in the debate about such moves, is the fact that for some products it is a normal part of their life cycle and that for every product moving to unscheduled status there are more moving from Prescription Only to Pharmacist Only.

5. NRT - The Harder You Work - the Luckier You Get.

The open selling of NRT and its move into supermarkets and corner stores has incurred a range of responses from community pharmacists, ranging from “knee jerk” retribution, or threats to send the first patient back to the purchase source, when information is requested. Others have decided to support brands that are sold only through pharmacies, and some have stated that they will price up the open brands to discourage sale through pharmacy. There has been little considered and rational thought on the matter, but it should be noted that the National Drugs and Poisons Schedule Committee (NDPSC) is the national decision making body that determines the safety of a product and which schedule it will appear. Because of the expert nature of the NDPSC, your are supposed to professionally rely on their decisions (even if you disagree with them). You can subscribe to an e-newsletter on their site. What follows is a table of NDPSC contacts that you are encouraged to communicate with. Below the contact table is a list of strategies that pharmacists may be able to align with.

6. NRT & GSK = OMS

So we have Nictoine Replacement Therapy going into supermarkets. If you ask GlaxoSmithKline, their hands were tied by the government, forcing them into supermarkets. If you ask other NRT providers, no pressure was placed on them by the government. I have previously commented on my thoughts on NRT in supermarkets, but now that only one brand and one company has launched into supermarkets, the next question is what do we do with them...

7. NRT’s. Where Does the Truth Lie ? - (or Who is Lying)

There is a perfect opportunity for Pharmacy to seriously stand up and be counted with this issue. The slipping pole of Pharmacy is not helped by well-placed and deliberate stories of Pharmacist's not offering CMI's, counselling or anything else that is supposed to be provided as a matter of course in a Pharmacy. It's the old story, if you make your bed, be prepared to lie in it. The sad truth is that many of these stories are correct. Equally true is that many of these stories emanate from sources hell-bent on wanting a slice of the action.

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