The i2P magazine is distributed by email on a monthly basis. Subscription is free and you can unsubscribe at any time.
From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 55: November 2006
Welcome to the November 2006 edition of i2P.
The year seems to have flown, and like most of you, I am still catching up.
To kick off this edition I would like to point readers to the link to global publications at the foot of the home page/email summary.
In the first publication (The Pharmacist Activist) you will find an American perspective on the Wal-Mart generic pricing scam.
If you look closely, something very similar is happening here in Australia with the supermarket-type pharmacies, but not to the same extent.
They are simply picking a small range of high turnover ethical items, not necessarily PBS lines, and selling them as "loss leaders" or something very close.
I think most pharmacists will be picking a more innovative solution than that.
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.
* Queensland triumph again in PSA Pharmacy Student of the Year Award
* Professor Andrew McLachlan - 2006 PSA Pharmacist of the Year
* Claire O'Reilly - 2006 PSA Young Pharmacist of the Year
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 through the "Contact Us" panel located on the home page.
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.
By a Staff Writer - Conferences and Events
As part of our information service, i2P informs on Conferences, Workshops and Seminars or 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).
* This month:
Pharmacy Continuing Education at Charles Sturt University 6th November 2006
(Wagga Wagga and Orange)
Rollo Maning will be speaking on Pushing the boundaries of innovation –the pharmacy of the future.
This presentation will give a critique of pharmacy practice with respect to the PBS and pose the question whether the Government (and taxpayer) is obtaining the benefit it should from the scheme.
An alternative model that gives scope for these considerations, and provides opportunities for practice improvement, will be proposed.
Rollo Manning - A Regular Column Reporting the News Behind the News
Pharma-goss --With Rollo Manning
* Generic Pricing- Who Benefits?
* Pressure Cooker Attacks Critics
* Management Training a Must
* Person to Watch
* Quote of the month
Neil Johnston - Management Consultant Perspective
Australian health commentators, including pharmacists, often claim that Australia has the world’s best health system.
There is a growing realisation that what is euphemistically called a health system in Australia is really an illness system, where people have to exhibit symptoms of a fully developed and recognisable disease and be at an advanced stage of illness, before the system kicks in and begins to provide funding and care.
The real killer of the 21st Century is chronic illness.
About 70 percent of deaths and costs are attributable to chronic diseases such as cardiovascular disease, diabetes and cancer that are all diseases that can be prevented or controlled.
The lack of preventive services exacts its toll in loss of life and billions of dollars in illness services.
Neil Johnston - Management Consultant Perspective
The debate has been dragging on for years.
What defines good drug information provided by pharmacists for their patients?
Consumer Medication Information (CMI) eventually became the mandated version, but there are so many flaws with the production and dissemination of this type of information that it satisfies nobody, except perhaps the manufacturer who was forced to produced it in the first place – and that only for legal reasons, rather than real benefit for patients.
Nobody denies that there is a need to have a mandated form of drug information that is to a certain standard. Standards can be progressively improved over time, particularly if there is a process to record suggestions from the stakeholders, namely all health practitioners and patients.
There is hope for CMI if such a process is developed.
There is also the possibility of leveraging CMI to provide a patient information service (for a fee).
Anthony Tassone - A Pharmacy Manager Perspective
Following the conclusion of negotiations for the Fourth Community Pharmacy Agreement between the Pharmacy Guild and the Federal Government, one of the ‘trump cards’ delivered by the Guild was the inclusion of $500 million of funding for Pharmacies in the provision of Professional Services.
This represented an increase from the $400 million contained within the Third Agreement (but also included a significant amount of which was agreed to roll over into the Fourth Agreement).
Heather Pym - A Division of General Practice Perspective
There has been quite a bit of interest shown since my last contribution where I outlined the role of the’ Cardiac Coach ’our Division has sponsored for the past four years.
The Cardiac Coach is a unique role in our Division although the large teaching hospital that has pioneered this role and sponsored it through State government Hospital re-admission risk program (HARP) funding has led the field in extending the coaching patients receive in hospital after their cardiac event to a phone coaching program in the community.
Although nurses primarily ‘coach’ their patients while in hospital, post event, with forward looking life style changes including exercise and diet, smoking cessation and education on medication compliance when they leave the hospital their allocated ‘cardiac coach ‘ who continues the role is usually, in this case a dietician.
Neil Retallick - A Friendly Society Perspective
It has been more than a year since the notion of a CSO (Community Service Obligation) being applied to pharmacy wholesale licences first surfaced.
Professor Ian Harper, its architect, has moved on to the Fair Pay Commission, leaving the industry to reflect on whether the system that has been introduced is fair for all the stakeholders.
Do we have what we thought we would have?
Is it working?
Dr David More - From a Medical IT Perspective
It seems that on both sides of the Pacific there is increasing interest in, and increasing difficulty with, working out an approach, and the supporting technology infrastructure, to meet public expectations for health information privacy and security while at the same time permitting health care providers the access to information they need, quite legitimately, to provide optimal care.
This short article aims to provide some talking points and base assumptions / positions that may be relevant in the very difficult policy area.
Pat Gallagher - An IT Consultant Perspective
When I was but a young whippersnapper happily engaged in the pharmacy industry, I worked for the best retail/wholesaler/manufacturing company the industry has ever experienced, I learnt a lot.
More importantly I still remember most of it.
I can say that this claim of ‘the best’ could be defended on any and many levels that are still valid today.
I have touched on these matters in early articles, relating the terrific outcomes in the efficiency of the closed loop operation, between supplier, wholesaler and retailer.
Whereby the secret of success was ‘information’; in that information was shared between the players to an extent that was considered weird in those days and, sadly, is still uncommon today.
Garry Boyd - From an Intellectual Capital Perspective
The world of Patency has come some way since 1714 when Queen Anne awarded Patent number 385 to Henry Mill for the “Great study, pains and expense” he endured in his quest to develop the first apparatus that would later become known as a typewriter.
After several stages of development by numerous persons and a fire in the US patent office that destroyed the only working model, a Gun and Sewing machine manufacturer named Remington finally produced a model that would endure.
Remington produced the first Scholes and Glidden model in 1874 with a basic keyboard layout that we still use with varying skill today.
Ken Stafford - A Consultant Pharmacist Perspective
At a party recently I became embroiled in discussion with a young pharmacy owner about the problem he has in providing “added value” to his customers by way of appropriate health advice.
He talked the problem I keep bringing up, namely that, in Australia, health has “no value”.
OK, we keep hearing about health problems and what needs to be done to reduce obesity, heart disease, stroke and other conditions but the current generation of Australians has grown up with Medicare and the PBS.
These two programs have taken away any appreciation of the actual cost of health care and medicines.
Bulk billing doctors (if you can find one) hide what medical care is worth and the average taxpayer appears to have no realization that the Medicare levy only covers about 20% of the health bill.
“I pay my taxes, so I have a right to medical care no matter what it costs” seems to be the common point of view and media stories about health costs running out of control just have no impact.
Chris Arblaster, PhD - A Consumer Self-Care Perspective
The recent announcement by Coles that it has purchased Pharmacy Direct has again intensified the debate about pharmacies in supermarkets and the potential negative impact this will have on the average retail pharmacy.
Added to this news is that forecasters in the FMCG segment are predicting that there will be a return to specialty and boutique stores at least for the minority market
Chris Wright - Dispensary Systems Perspective
There seems to be a plethora of assisted dispensing machines on the market now, several of which are finding their way to our shores.
Most can be described as ‘in house dispensing’, but some, like the locally developed Bluepoint and the US Scriptpro Telepharmacy are best described as “remote dispensing”.
Please note that for the purpose of civility I’ve refrained from using the expression, "Out house”.
Dr Andrew Byrne & Associates - A Harm-Minimisation Research Perspective
Editor's Note:Dr Byrne (and his associates) advocate for better policies which are proven to reduce risks for drug users and the general community under a framework in parallel with Australia's official policy of harm minimization.
The findings of the New South Wales Drug Summit recommend better access to methadone, detoxification and other dependency treatments.
It also advised investigating alternative services such as supervised injecting centres, leading to the opening of the Sydney Medically Supervised Injecting Centre in 2001.
Dr Andrew Byrne has been involved in opioid treatments from a primary care background for 20 years at the same site in Redfern, an inner suburb of Sydney.
He is recognised worldwide as a specialist in the addiction field and was involved in the seminal stages of the Chapter of Addiction Medicine, Royal Australasian College of Physicians.
He received the Dole-Nyswander award from the American Association for the Treatment of Opioid Dependence in April 2006.
A range of publications on pertinent strategies for harm-minimisation is available for dowloading at: http://www.redfernclinic.com/publications/
These e-publications may prove to be of practical interest to those pharmacists interested in dependence and addiction
This month we are pleased to publish a second conference report prepared by Dr Richard Hallinan.
Dr Richard Hallinan has also had an interest in addiction medicine for about 20 years.
Since joining the practice in 2000 he has published several key papers on subjects including hepatitis C and optimising methadone dose levels.
He also has performed studies on hormones, mood disorders and related matters in dependency patients.
Dr Hallinan also worked for years as a professional violinist in both Australia and in Austria.
Barry Urquhart - International Conference Keynote Speaker
I transmit this edition of our periodic e-zine from a hotel at the base of Uluru (Ayres Rock) in Central Australia.
Everyone is entitled at least once in their life to the right of experiencing the sun rising over this magnificent edifice, on the flattest, driest, inhabited continent on earth.
The symbolism of the occasion is not lost on anyone. I’m here to address the members of the Australian Petroleum Agents and Distributors Association at their annual national conference. It really is a new dawning for an industry and an economy that has and continues to experience rapid change.
For those being subjected to intense competition, price discounting, market dominance by a few major national and trans-national competitors, increasing rates of technological change I draw your attention to a sign on my desk at our offices in metropolitan Perth.
“This day will pass”
Each day is a new challenge, of opportunities
With the serenity of the Australian outback, against the backdrop of ochre coloured landscape which has been shaped over millions of years, the trials and tribulations of our own little microscopic universe seems miniscule indeed.
It is a new dawn.
By a Staff Writer - Publications to Note
This section of i2P is designed to be an experimental section to introduce other publications that have similarities to i2P, but are based in other countries.
The globalisation of Australian pharmacy started around the year 2000.
It has had minimal impact up to 2004, but that is now changing and i2P must reflect that change.
There are many aspects of globalisation not yet fully understood, but I think that to most of us, globalisation means that we must be quicker on our feet and have pharmacy practices with sufficient critical mass to withstand global pressures.
Depending on the model of pharmacy chosen, and its location, global pressures will vary.
As pharmacists we must begin to open up our minds to new ideas and innovative ways of delivering pharmacy practice.