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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 50: July 2006
Welcome to the July 2006 50th edition of i2P in its current format (there were many more before this format dating back to the year 2000).
We must also apologise for being late (by one week) that is a direct result of the increase in “busyness” exacerbated by end of financial year activities.
Despite our late publishing date, we have still presented with a great selection of diversified topics, all concerned with the betterment and the advancement of the profession of pharmacy.
By a Staff Writer - Publications to Note
As part of our information service, i2P informs on Conferences, Workshops and Seminarsor press releases 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).
* New Therapeutic Guideline - RHEUMATOLOGY (VERSION 1, 2006) Therapeutic Guidelines:
Rheumatology. A brand new title — practical help for the one in six patients presenting with a musculoskeletal complaint, from back pain to obscure vasculitides.
* Improving Medication Safety: sharing the lessons learned
28-29 September 2006
Sydney, NSW, Australia
Change Champions invites participation in its next Toolkit Seminar, Improving Medication Safety: sharing the lessons learned by submitting an abstract to present at the seminar.
Aims of Seminar
· To share information about initiatives, structures, systems and strategies that have been successfully implemented and have improved medication safety for patients.
· To showcase best practice, models of care, models of service delivery, tools and resources that have been effective in improving medication safety and/or reducing medication errors.
* 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 !
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.
Peter Waterman - The Latest from the Pharmaceutical Society of Australia
PSA News - 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.
* Complementary medicines: optimising health in the ageing community?
* Wanted: Australia's Top Pharmacists
* Are you Australia's top pharmacy student?
Rollo Manning - A Regular Column Reporting the News Behind the News
Pharma-goss - With Rollo Manning
* THE FUTURE IS HERE
* A CHALLENGE AHEAD FOR PHARMACY BOARDS
* WHO REALLY OWNS THIS PHARMACY?
* THE NEED FOR HONESTY
* QUOTE OF THE MONTH
* THINK TANK
Neil Johnston - Management Consultant Perspective
In the April edition of i2P I wrote an article entitled “There is no Fourth Agreement” much to the concern of many pharmacists who thought I was on the wrong planet.
I also posed the question:
“When is an agreement not an agreement?”
And I answered my own question along the lines of:
”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.”
I don’t think too many pharmacists would argue with the above statement now, given so many changes have occurred outside the Fourth Agreement.
In the May edition I noted eleven confronting issues for pharmacy that had to be resolved, starting with privacy.
Privacy issues were elaborated on in June i2P.
This month I would like to extend some of the other issues documented, which include delegation of dispensing, S2/S3 sales, new staff, illness certificates, patient mentoring and charging professional fees.
Robert Forsythe - Globetrotting Community Pharmacist Perspective
In June the UK Government announced that General Practitioners will be graded according to the quality of the service they provide. (See The Australian ).
Most of us feel quite comfortable about the application of rating systems to hotels - it allows us to make a more informed choice about where to spend our money and what is good value.
The QCPP program is now well established in Australia with 87.1 % of pharmacies now accredited. (Source www.QCPP.com.au)
Neil Retallick - A Friendly Society Perspective
Since late last year there has been a lot of focus on one outcome of the Guild/Government Community Pharmacy Agreement - the decision to introduce a CSO into pharmacy wholesaling.
The activity levels have been building across the country with a final crescendo last week when all wholesalers wishing to be accredited as CSO (Community Service Obligation).
Distributors had to have their tenders into the Department of Health and Ageing.
The briefing held in Canberra during June saw all the power players in one room - the Pharmacy Guild, the NPSA representing the Big 3 wholesalers and the Department of Health and Ageing.
Anthony Tassone - A Pharmacy Manager Perspective
Throughout the drawn out negotiations of the Fourth Community Pharmacy Agreement between the Federal Government and the Pharmacy Guild, Federal Treasurer Peter Costello was busy telling anybody who would listen that the Pharmaceutical Benefits Scheme (PBS) was in urgent need of reform.
The PBS has already seen significant reform in the past 12 months with the advent of the Safety Net 20 Day Rule applying to how soon patients receive Safety Net entitlements and the price they will pay depending on frequency of dispensing of prescriptions.
There has also been the Generic Price decrease of 12.5% to all medications in a therapeutic group after the introduction of a new generic product.
Furthermore, there has been the increase in patient co-payment of prescriptions for both concession cardholders and general patients, along with annual indexation of Safety Net Thresholds.
These measures have resulted in a significant 'bottoming out' of the PBS, as it now grows at a rate of around 2%, lower than that of inflation.
Chris Arblaster, PhD - A Consumer Self-Care Perspective
The proposed changes to the PBS and activities of competing retailers both in and outside of pharmacy is making many progressive pharmacies reconsider how they should provide an improved retail offer.
ASMI in collaboration with The Sales Factory has commenced a new service that provides important information about why a sale is made. Currently there is audit data for what is going into pharmacy and what is going out of pharmacy but not what is happening at the point of purchase to gain an understanding of how to improve category management and profitability.
Pat Gallagher - An IT Consultant Perspective
I have writer's block.
Not that I don't have many subjects that I can pontificate on; there are heaps of issues, under the umbrella of ICT in pharmacy and e.health, worthy of discussion.
It is that merely I have written about them all.
Sometimes more than once.
So lets see from this brief list what deserves another twirl around the digital electron pages of this great publication.
Barcoding, PDE numbers, e.scripts, death by data, central product repositories, electronic health records, supermarkets, online pharmacy, internet lead change in customer expectations, broadband, turnover orders, selling pharmacy sales statistics, what is the score-comparisons between similar sized and located pharmacies, leadership in the profession getting on top of e.health issues, changes over 50 years, hardware and software, middleware and wetware, standards, garbage at the speed of light, PBS, generational change, Department of Illness and Death, privacy and security, governors and HealthConnect, and ...... on and on.
Heather Pym - A Division of General Practice Perspective
At a meeting I was attending last week the question was asked 'How do GPs and pharmacists communicate.
And what about?
How is QUM communicated? "
The attendees at the meeting were pharmacists, medical scientists, some GPs , a specialist and some academics.
An interesting group with the capacity to produce some remarkable outcomes for the project we were involved in.
These were keen people with a lot of drive, highly intelligent and motivated.
I have been thinking about the question since and I wonder if any studies have demonstrated that this happens, what benefits have been noted and where it does not, what results.
Ken Stafford - A Consultant Pharmacist Perspective
After 40 years in the profession I've finally decided I've had enough of the continual complaining by my fellow pharmacists about how badly done by they are.
The "government is out to get us", "the supermarkets want to take over", "we're nothing but unpaid government lackeys" and all the other stories appearing in the pharmacy press are really annoying me.
For about fifteen years now pharmacy "leadership" (I use this word with a degree of sarcasm) has acted like the proverbial doormat when anything contentious comes up.
A prime example was agreeing to the reduction of PBS margins to the current ridiculous level where a pharmacist will dispense a medication costing $5-10000 for the huge mark-up of $40! What other profession (or retailer even) operates on a margin such as this?
What happened to that funny line of bones running down the back of other professionals?
You know the one I mean - I think it's called a spine.
Chris Wright - Dispensary Systems Perspective
Karalyn Huxhagan has penned a fine article on the HMR’s recently.
While I agree with the model in principle, and the strategic significance of making it a “groundhog day” issue in relation to shoring up the beachhead, I have concerns about how best to determine the suitability of a Pharmacist to conduct the task.
My own view is that the participating Pharmacist must be the regular “Community Pharmacist”.
Given the shortage of Pharmacists’ in the hospital system, employing a Pharmacist attached to a hospital may prove to be logistically difficult.
An independent contractor or a Pharmacist attached to a State community health program doesn’t ring my bell either.
If “Community Pharmacy” is responsible for conducting HMR’s they should fit into an appropriate model.
As I’m philosophically and commercially opposed to those large “barn like” supermarket styled Pharmacies that are often decked out in colours that are more suited to the specials bin at Bunnings, it seems reasonable to suggest that genuine “Community Pharmacy” operators be accredited to conduct HMR’s rather than anybody with a section 90 approval.
Barry Urquhart - International Conference Keynote Speaker
Around the world the focus in business is turning to cashflow.
Budgets are being tightened and inventory levels trimmed.
This is being reflected in the currently high available (unsold) housing stock levels in the United States of America.
Increasingly, nervous home builders are shaving margins to lower inventories and to free up cash. However, the flow on consequences are being evidenced on the lowering of pricing levels of homes, in a significant number of marketplaces.
The equity enjoyed by home owners has been adversely affected.
This is, in turn, affecting consumer behaviour and buying patterns.
A key message is that discounting is not a viable option.
Unprofitable cashflow enhancements achieve little in the intermediate to longer terms.
It has been noticeable that focus of management workshops which we have facilitated has tended to centre on the identification and use of appropriate promotional media for “Star” products.
That is, the products and services that have the capacity to attract attention, generate sales and provide for improved profit margins.
This is astute strategy framework for an over-communicated society, in which many businesses have stretched and limited resources.We do hope that the following texts provide some invaluable insights on the nature of the prevailing marketplace.
James Ellerson - A Marketing Consultant Perspective
A recent edition of i2P highlighted a US program sponsored by drug manufacturers, utilising direct nurse contacts with patients to provide drug information, and to supervise patient compliance.
Regular contact by telephone coupled by a calendar of scheduled home visits, has proven to be a popular service for patients.
American GP's can request this service from a private company that is a consortium of Pharma manufacturers i.e. the nurse does not work for the GP as an employee and is not directly employed by a pharmaceutical manufacturer.
Through this method, manufacturers not only share the cost of this service, but are able to improve sales performance for those (mostly expensive) drugs that patients may stop taking, due to side effects or lack of information.
However, the manufacturers are now supplying drugs directly to nurses, bypassing pharmacy wholesalers and pharmacists.
By this method, the program becomes virtually self-funding compared to the previous business model, utilising margins saved from wholesalers and pharmacists and income provided by the restoration of previously declining sales.