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 68: February 2008
Welcome to the February edition of i2P- Information to Pharmacists, the first for 2008.
This year might prove to be the "make or break" year for some pharmacies, in that cash flow is beginning to diminish as intervention and competition heats up across the board.
The impact of government "reforms" is being felt in the form of PBS price reductions, and supermarket-type pharmacies are beginning to impact in increasing numbers of geographical areas in which they are becoming established.
Detrimental impacts on pharmacy markets may also appear this year as some elements seek to impose additional regulations on compounding and complementary medicines.
The attacks on pharmacy will no doubt continue to escalate to the year 2010, when the Rudd government will quite likely approve of the deregulation of pharmacy ownership.
Remember, pharmacy deregulation was first advanced by the Hawke-Keating governments, and only interrupted by the support created by John Howard.
Coles are reputed to have registered trade names, trademarks and slogans pertaining to pharmacy ownership, signifying they are increasing their state of readiness for post 2010.
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.
Indigenous Pharmacy Student Triumphs
* Important update to PI for Rosiglitazone containing products
Katie Butt - From a Good Prescribing Perspective
The National Prescribing Service (NPS)is a valued independent resource for good and unbiased prescribing information and education.
Given the marketing pressures applied by global drug companies, Australia is blessed to have such a resource.
Pharmacists are moving closer to a prescribing role within the health system and it is appropriate that i2P promote the message of the NPS.
This Month: * International line-up for NMS 2008 * Generic medicines training module for Pharmacy Assistants * New safety information about glitazones in NPS RADAR * NPS issues new fact sheet on Osteonecrosis of the Jaw * Monitor and support patients on varenicline
Bob Bowden - Media Contact for the Australian Self Medication Industry
For over 30 years, the Australian Self-Medication Industry has represented companies involved in the manufacture and distribution of non-prescription consumer healthcare products and related firms.
ASMI is the peak industry body for the Australian self-care industry including consumer healthcare products ranging from over-the-counter medicines (OTC) to complementary medicines.
Also represented by ASMI are companies providing manufacturers with services, such as advertising, public relations, regulatory consultancy, legal advice and industry statistics.
Topics for this month: * Tightening of controls over complementary medicines not warranted
* Media reports regarding alleged misuse of Nurofen Plus
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 comment on any news item by contacting the editor through the "Contact Us" panel located on the home page.
News items and topics displayed 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 will be published through the "Letters (Your Say) " column.
By a Staff Writer - News Items, Background Information and Items of Interest
Organisations with pharmacy connections are invited to share their news, product releases or opinions in this column. This month: * Buscopan growth plans
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.
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 event information will be found here, but PSA news 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).
* Change Champions Seminar - Improving Medication Safety
* International Line-Up for NMS 2008
* National Pharmacies-Calendar of Events - Pharmacy 2008 Conference
Rollo Manning - A Regular Column Reporting the News Behind the News
Pharma-goss With Rollo Manning
* ANOTHER CO-PAYMENT INCREASE FOR PBS SCRIPTS
* PSE - bulk supply or retail packs?
* Stilnox again
Neil Johnston - Management Consultant Perspective
Ron Paul is a candidate in the US presidential elections to be held in November of this year.
He has been an advocate for freeing up the health system, and his message is beginning to resonate with many voters (and this writer).
He is also a respected physician and is beginning to attract a large following to his cause.
He recently raised $5.1 million in the latest fund-raising quarter, surprising much of the political world, and perhaps even himself, with his success.
Paul’s supporters, who maintain a notable Internet presence, are drawn to his message of “limited government and following the Constitution” -- and they’ve been coming out in full force to help give Paul a real chance in the upcoming presidential elections.
Earlier this year, Paul introduced a bill (The Health Freedom Protection Act) that would strongly and positively affect many natural health organisations, practitioners and advocates.
His ideas have the power to prompt real and positive change in the U.S. health care arena.
The main thrust of his campaign is threefold.
* He wants to expand the ability of Americans to use alternative medicine and new treatments.
* He opposes legislation that increases the FDA‘s legal powers.
* He believes the government should never have the power to require immunisations or vaccinations.
This brings him into major conflict with the powerful drug lobby that is believed to fund a number of prominent US politicians for campaign purposes.
The following text of his message was published in Modern Physician Online on the 17th December 2007. While the US health situation is generally regarded as "poor", many aspects that system bear remarkable similarities to that found in Australia.
I think Ron Paul's message is worth digesting in an Australian context, and it follows on from here.
Neil Retallick - A Friendly Society Perspective
The community pharmacy marketplace today is almost exclusively comprised of independent, registered pharmacists who collectively own around 4,500 pharmacies across Australia.
Since 1928, these pharmacists have funded the Pharmacy Guild of Australia.
According to the Guild’s website, “The Guild is a national employers' organisation which functions as a single legal entity rather than a federation.
The development of policy is the responsibility of the Guild's supreme governing body, the National Council, on which all State and Territory Branches are represented. Implementation of policy is overseen by the National Executive and effected through the National Secretariat.”
Con Berbatis - A Pharmacy Researcher Perspective
Editor : Primary care sectors with doctors serving as coordinators of health resources form the basis of national health systems. Internationally, primary care varies in structure, cost and outcomes.
Differences in national health systems and primary care have shaped the income and practice of community pharmacists in the UK, USA and Australia.
In Part 1 of this two-part report, Con Berbatis compares the main elements of national health systems and primary care which have shaped Australian community pharmacy .
This forms a basis for identifying opportunities in primary care from the findings of a 2007 study of international primary care in Part 2.
James Ellerson - A Marketing Consultant Perspective
I suppose it is stating the obvious.
The doctor groups want to see most medicines confined to Schedule 4 of the Poison's Schedules.
The Australian Self Medication Industry would like to see medicines rapidly down-scheduled to the level where they can be marketed through high volume outlets such as discount pharmacies and supermarkets (also allowing direct-to-consumer advertising by manufacturers).
Well philosophically they would like more medicines in Schedule 3 but have not developed a proper system to handle the process, because their current models of pharmacy do not allow for sufficient pharmacists to be involved in the counseling process, and the discount pharmacies cut the prices to the extent that all but “lip service” counseling is affordable for the patient.
And at that point, professional associations become critical of pharmacy practitioners, but are unable to provide solutions, giving manufacturers and others, a chance to deflect the problem and paint pharmacists as “villains” with Choice (as a consumer association) cheering from the sidelines.
It also underscores an unrecognised opportunity for pharmacy to develop a unified solution to the continuing problem of a minority segment of the population wishing to continually harm themselves in some way.
Stephen Carbonara - From an Independent Professional Pharmacist Perspective
This year we have witnessed the introduction of optometrist prescribing, a development which I feel was long overdue.
Another development has been the move to de-schedule phenylephrine/paracetamol products, a decision which I do not whole-heartedly agree with.
Nonetheless, these two recent movements highlight a move of progressive downward regulation of medicinal substances.
Now I’m really interested to see whether or not the rate at which substances either drop off the S2 shelf or depart from the doctors’ control, will equal the rate at which they become S3 or enter the realm of pharmacists’ control?
Terry Irvine - Community Pharmacist Perspective
Lately, the news has focused on the problems of people taking large doses of Nurofen Plus, or Panafen Plus for the codeine content of the tablets and in the process knocking their kidneys out with the ibuprofen.
Those old enough can remember people taking APC powders for the caffeine and having the phenacetin take out their kidneys.
In the case of caffeine people suffered from caffeine withdrawal in the morning and had to take a powder to treat the headache, then the cycle started all over again.
Peter Sayers - Pharmacy Practice Management Perspective
There is a war about to errupt in the US in which compounding pharmacists, a significant group of anti-ageing physicians and health professionals, are squarely in the front line.
It seems very much about corporate greed and the US system of drug regulation that appears to have become corrupted.
The Food and Drug Administration (FDA) is almost totally funded by the proceeds of the registration of a manufacturer’s products.
The potential to be “soft” on manufacturers rises exponentially with any possible loss of revenue that may occur if a manufacturer cannot patent and register a product e.g. as in the case of bio-identical hormones.
The war has the potential to errupt around the world, including Australia, as global drug manufacturers seek every means of controlling the sale of medications to exclude any form of competition.
Compounding pharmacies and community pharmacies have become unwitting pawns in this race to world domination.
Australian pharmacists need to study and support their US “cousins” in the battle that will impact here in Australia, to an extent that will only be limited by how well local pharmacists organise to face this threat.
The following is a press statement released by the International Academy of Compounding Pharmacists.
Chris Wright - Dispensary Systems Perspective
There is no doubt flying a banner is good for business, providing of course you can afford to belong.
The other major factor in deciding whether or not to belong to a group and enjoy the sometimes dubious benefits made available by flying their flag is the culture.
For example, there is little point in joining a “supermarket” type brand if you are in the habit of actually engaging your patients in meaningful conversation.
Those pharmacies that are so obviously loathed by those that are charged with representing them to the degree that they are referred as “shitty little pharmacies” (SLP’s) are more often than not unbranded.
Ken Stafford - A Consultant Pharmacist Perspective
Consultant pharmacy, in its present form, has been around for over ten years and is attracting increasing numbers of pharmacists wanting to “do things differently” - but are they?
I remember much of the discussion about establishing AACP and its role in accreditation.
The original triumvirate of PSA, PGA and SHPA rapidly broke up with our hospital colleagues pulling out, possibly an unfortunate action as it removed input from a group with the greatest pool of experience in performing medication reviews and interacting with prescribers.
Despite this hiccup AACP became fact and consultant pharmacy was on its way.
Chris Wright - Dispensary Systems Perspective
This writer confesses to being just slightly intellectually dysfunctional, so please take this piece with the proverbial grain of salt…
The Federal Minister for Trees, one Peter Garrett, has been burning the midnight oil furiously lately, and has concluded that “plastic” shopping bags have a future as fragile as the Indian cricket team…….apologies to Indian friends.
Certainly, a better solution must be found.
But as is often the case, solutions are easier to find than actually understanding the problem.
In this case, we have an unwanted commodity, (being plastic shopping bags) and no real escape plan.
Garry Boyd - From an Intellectual Capital Perspective
Isn’t it strange that we see businesses as having a particular “image” when it comes to branding?
MacDonald’s for example, hold themselves out to be “Restaurants”, which of course they are not in the considered opinion of those that dine in restaurants, bistros, trattorias or cafes.Pharmacies used to be universally identifiable as being the place where you got your pills and purchased condoms, staffed by boring people that would never be described as approachable.
Today, pharmacies are often large places, full of bargains and of excitement, bling, eager staff, but somehow devoid of personality.
Heather Pym - A Division of General Practice Perspective
The GP network I work in has been educating GPs on the evidence for best practice in the prescribing of antibiotics for nearly 10 years using NPS resources with case studies, clinical audits and a systematic visiting program to individual GPs.
We have also educated parents and carers at Child Care centres and have had a consumer campaign of advertising messages such as “Common colds need commonsense” widely throughout the city on bus stations and in GP surgery waiting rooms.
Data on antibiotic prescribing reflects that the messages are getting through both in terms of prescribing rates and the choice of antibiotic prescribed.
This augers well when considering the main aim of our education is to preserve the effectiveness of antibiotics when they are needed and to stay the development of resistance to bacterial strains.
However lately I have been concerned when talking to GPs about the pressures they meet to prescribe antibiotics from their patients.
Rollo Manning - A Special Report on Indigenous Health from Northern Australia
It’s a new world with new diseases – don’t expect me to understand
Harvey Mackay - From an International Speaker, Author, Columnist and Consultant Perspective
Editor's Note: I have been a subscriber to Harvey Mackay's e-newsletter for some time.
His writing is direct and simple with a "homespun" philosophical style, and this is what has made Harvey one of the best known social and business management commentators in the US.
But there is nothing simple about his underlying message- it is very much "to the point".
While reading this month's message from Harvey, it struck me that the principles espoused could very easily apply to Australian pharmacy, in that simple technologies can be introduced to marry up with some (not all) of pharmacy patients and customers.
Trying to implement the big solutions (top down) can be time wasting and too complex for most participants. Harvey explains why in his column...........
Dr David More - From a Medical IT Perspective
Last week a useful summary of the state of E-Health in Australia appeared in the Australian (dated January 18th, 2008), reporting on the submission prepared by the Health Informatics Society of Australia for our new Treasurer’s May 2008 budget round.
Written by Karen Dearne under the heading of "Australia's e-health in dire straits", it commences by stating:
"THE Rudd Government should bypass the National E-Health Transition Authority and fund a key health stakeholder group to develop an "agreed vision and plan for e-health", the Health Informatics Society of Australia says."
Dr Andrew Byrne & Associates - A Harm-Minimisation Research Perspective
Depot naltrexone use for opioid dependence in Australia: large-scale use of an unregistered medication in the absence of data on safety and efficacy.
Barry Urquhart - International Conference Keynote Speaker
Is it worth it?
Celebrity endorsement is a bit like that. The concept raises more questions than it answers.
Review of celebrity endorsement is timely, given the fact that in 2006 below-the-line expenditure exceeded that of above-the-line outlays in Australia.
Included in the former subgroup are activities which centre on promotions, merchandising, the hosting of events, product sampling and, yes, celebrity endorsements.
That is an issue which must rightly be addressed and countered by the mass media channels of television, radio, print and outdoor billboards, because of and their contribution to the status of celebrities.