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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

More Archives
We are in the process of moving all of our articles to the new site.

In the meantime you can find them on the old i2P site.

Issue 81: April 2009



Welcome to the April edition of i2P (Information to Pharmacists) E-Magazine. And it would appear that momentum is building on the pharmacy front with the pending release of PGA systems and program information, using the APP Conference as the delivery vehicle, early in April. With all the hype surrounding this event (including the stated threat to remove undesirable attendees, even if they match the eligibility criteria to attend) one could be excused for thinking that there is a hidden agenda under way. Some big issues (for the PGA) include the launch of eRx and its competitor, Medisecure, e.prescription exchanges and the Mirixa system. There is a lot riding on the successful launch of these systems in terms of PGA future revenue and tension is building accordingly.

PSA Press Releases

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. This Month:  * PSA LAUNCHES THE NEW EDITION OF AUSTRALIA’S EVERYDAY GUIDE TO PHARMACY PRACTICE – APF21  * PHARMACISTS’ CARING REPUTATION BASED ON EXPERIENCE  * PROJECT STOP BEST VEHICLE IN WAR AGAINST ‘ICE’

National Prescribing Service Press Releases

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:  * NPS RADAR reviews venlafaxine metabolite   * Avoid further costs by taking your medicine as prescribed   * NPS audit reveals positive prescribing practices in hospitals   * 11th Evaluation Report demonstrates value of NPS * Get to know your medicines with the NPS Medicine Name Finder  * Be aware of limitations in clinical software systems

Australian Self Medication Industry Press Releases

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:  * ASMI comment on children’s cough and cold medicines  

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.

Find it Here

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). This month:              * Pharmacy Expo - The Premier Pharmacy Practice Event           * Pharmacy Management Conference 2009

Around the Traps

Organisations with pharmacy connections are invited to share their news, product releases or opinions in this column. This Month:  * PBS LISTING PROVIDES EASIER ACCESS TO IMPORTANT ANTIFUNGAL MEDICINE

Health News From Around the World

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.

Your Say

Your Say is the column reserved for subscriber (or other source) comment relating to i2P articles, or reportage or general comment on the profession and industry at large. All posts must be identified, but the editor will suppress name and contact details if there is a sensitive reason.

Pharma - Goss


MOU Reflects the Changing Dynamics of Community Pharmacy

On the 17 March, the Pharmacy Guild of Australia and the Australian Friendly Society Pharmacies Association signed a Memorandum of Understanding (MOU). Given the long history of animosity between these two community pharmacy organisations, the inking of this agreement represents a seismic shift in the Australian pharmacy landscape.

A Moment in History for the "Friendlies" and the PGA

In a low key move, the Pharmacy Guild of Australia (PGA) and the Australian Friendly Society Pharmacies Association recently signed a Memorandum of Understanding (MOU). By this single move, the Australian Pharmacy landscape has immediately changed to reflect a new sense of political unity and stability. Under the MOU the PGA is recognised as the single negotiating body for pharmacy and the Friendly Societies derive the flow on benefit of government funded programs, to which previous access was difficult. At i2P we have always recognised that Friendly Society pharmacies, and in particular the National Pharmacy Group, have represented an efficient pharmacy model, successfully integrating pharmacist and non-pharmacist management deployed to sensible delegations, and under a corporate umbrella structure. And the model has survived and prospered given the range of difficulties and distractions thrown at it over the years.

Prescribing or Selling? Smoking Cessation and all that!

In New Zealand the Ministry of Health is changing the way pharmacy is being funded for supplying product for smoking cessation. The latest bright idea is that pharmacies, rather than selling Nicotine Replacement Therapy (NRT) with normal on cost margins, is to fund it as for other prescription items i.e. a basic cost price for the product plus a 4% margin plus the dispensing fee. This would provide a slightly smaller margin than pharmacies are currently receiving for handling this product, but not a dramatic change.

Climate Change, Health and Pharmacy - The New Challenge - Commentary by Con Berbatis

Editor's Comment: A recent news item published online by the Far North Coaster E-Magazine caught my eye because it was linking lifestyle illness to climate change. Research into the effects of climate change on health has been picked up by a number of researchers, including our own Con Berbatis who has had two reports published in i2P regarding this health issue. Our summer of 2008-2009 was one of the most extreme on record and I think dispelled any doubts that something is indeed happening to our climate. As pharmacists are in the frontline of primary health care, they need to have an understanding as to what problems they may be asked to deal with. Con Berbatis will continue to report on his research into climate change for the benefit of i2P readers from time to time, but pharmacists are urged to come to grips with this particular aspect of medicine and how they may assist affected patients who are likely to be the entire Australian population. People aged 60+ are most likely to be affected, and they just happen to be the fastest growing demographic of the Australian population. Coming to grips with health issues from climate change will represent a continuing challenge for pharmacy.

Skeptics, Pharmacists and the Evidence Base - Commentary by Gerard McInerney

Editor's Introduction: A range of media received an open letter from the Australian Skeptics Inc in March 2009 that implied that Australian pharmacies and pharmacists were being unprofessional in selling "quack " products, that had nil or inadequate evidence to support their sale, and that some dubious services were also supported (iridology, homeopathy and naturopathy). As editor for i2P E-Magazine I agreed to seek some official comment, or failing that, comment from a pharmacist with an expert working knowledge of pharmacy practice. Correspondence then took place with Gerard McInerney, president of the Pharmacy Board of NSW, and he agreed to submit our request to the full board. The Pharmacy Board pointed to a range of material published in their regular bulletins, and these were collated by Gerard and forwarded to form part of this Pharmedia commentary. While the skeptics pointed mainly to complementary and alternate medicines, I believe that the debate needs to be extended to the so called "real medicines". Some manufacturers of certain classes of these drugs "cherry pick" the positive bits of evidence garnered through large scale clinical trials and suppress or hide any adverse findings. This occurred recently with some of the anti-inflammatory drugs (causing heart failure) and has now extended to certain antidepressant drugs. One manufacturer is currently facing around 9,000 lawsuits in the US because of failure to disclose the drug was likely to cause diabetes. Trust in these instances has been destroyed with both consumers and health professionals. I would recommend subscribers to read Harvey Mackay's column in this edition relating to trust in business. Pharmacists have worked hard for many years to build trust with their communities, and it would be very sad to see this element damaged. Trust is the most important component of any professional practice for without trust you do not have a profession. Therefore, we recommend that all practicing pharmacists evaluate what the Skeptics have to say, and if any part of your daily practice needs reviewing, then please take the time to undertake a proper adjustment. Perhaps other pharmacists might like to make a comment as a "letter to the editor". What follows is an open letter from the Australian Skeptics together with the selected extracts compiled by Gerard McInerny from the Board Bulletins..

Advertising on Prescription Repeat Forms - Commentary by Stephen Carbonara

Editor's Comments: For some time it has been customary for pharmacists to advertise on prescription folders and of late, the tear-off strip of paper on the edge of a repeat form. Mostly, this has taken the form of low key subject matter in keeping with the provision of a range of professional services, but now it seems that contentious forms have crept in viz. the advertising of weight loss systems and products. One Victorian GP has taken exception to the association of this type of advertising with his prescription form and the Victorian Pharmacy Board has agreed with his complaint. As pharmacy advertising has become more extreme, particularly with the rise of supermarket pharmacies, i2P put this issue out to Stephen Carbonara, one of our regular writers, for comment. Because advertising is sensitive to the extent that it is supposed to accurately inform patients and general customers, and is seen collectively by all these people without discrimination, they can be forgiven for thinking the attitudes and values expressed by one pharmacy may be common to all. While the TGA rules what is or is not legally correct, the profession of pharmacy needs an Advertising Code of Conduct to determine what is ethically and professionally correct. The Victorian Pharmacy Board sees advertising on the side of a prescription form as being unprofessional, and in a different setting the NSW Pharmacy Board does not see the discounting of products such as Panamax as unprofessional because of lack of evidence of abuse of the product. But what if Panamax was advertised on the edge of a prescription repeat at a discounted price? Advertising is becoming a more contentious issue these days and it would seem that some form of self regulation is desirable - something that gives Pharmacy Boards an intervention level to protect the profession and the general public. And when will state pharmacy boards speak with one voice? What are you feelings on the matter? Let us know through this email link and have your thoughts published as a letter to the editor.

The Australian Pharmacy Professional Conference - What is There to Hide? - Commentary by Karalyn Huxhagen

From the Editor: As the date for the Australian Pharmacy Professional Conference (APPC) came up on the calendar, I was interested to see what was being publicised on their website in addition to the major items already released to various pharmacy media. To my surprise I noticed the item highlighted in red text below and wondered who the paranoid person was who actually dreamed up the insert. Siege mentality comes to mind. But there must have been a reason that we poor unsuspecting pharmacists were unaware of. Was it because some of the attendees may be too outspoken, or was it because some sensitive information needed to be "managed". Managing information and exercising control of the media only occurs when you have something to hide, or more importantly, something that could be misconstrued as to motive. So I decided not to attend this year because the refund for refusal of entry only extends to the refund of the registration fee and not to the costs of actually getting there or any other cost incurred e.g. locum services. And this occurred just as we were giving the PGA a commendation for forming up a Memorandum of Understanding with the Friendly Society Pharmacies. Two steps forward and one step backwards. I began thinking thinking that I might qualify as one of the targets. Or maybe it was Charlie Benrimoj they were still smouldering about or again, maybe someone else who might publicly disclose some incompetence that is currently, or about to occur. Mirixa, SureScript and eRx are programs that would be making PGA executives a bit nervous. eRx is a big gamble and because it does not employ industry standards, is not likely to get traction from government sources. SureScript will probably succeed because it is controlled by GP's who initiate the e-scripts in the first place. Both charge up to 25c per script to pharmacists and no charge to doctors. This is an enormous cost to the health system that is eventually attached to taxpayers and there are issues of privacy and sale of information that have yet to be disclosed. Also, how the information is to be joined to a patient health summary (because prescriptions are a part of this) and has the issue of sharing privately and securely been solved. Knowing the difficulties, I think that this issue will remain unresolved for some time yet and at a cost that is not necessary. Mirixa is the other system being released. A system that was not developed in Australia and will have to be utilised by pharmacy owners who already have difficulties in running existing clinical programs. But battening down the hatches is a rather uncreative way of drawing attention to the fact that all is not well and there is obviously something that must remain hidden.

Understanding Indigenous Health

Editor's Note: Currently there is a greater focus in repect of Indigenous health. And about time, some would say. Only very small pockets of the pharmacy profession have attempted to come to terms with this major problem, and they genuinely need your management assistance. Rollo Manning could well be regarded as the pharmacy expert in indigenous health, and he vigorously defends the rights of indigenous people to enjoy good health - just like the rest of the Australian community. Rollo's sympathetic insights reflect his long association with, and understanding of, the issues surrounding indigenous health.

QUMAX - One Year on and Where to From Here

Earlier this month the PGA (Pharmacy Guild of Australia) and NACCHO (National Aboriginal Community Controlled Health Organisation) hosted a meeting in Canberra to discuss how QUMAX (Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander Peoples) is going and where to from here. The meeting was attended by state affiliates from NACCHO and the State Quality Use of Medicine facilitators employed by the Pharmacy Guild. Other attendees included the Department of Health and Ageing employees who are involved with this program and people employed in the various community controlled health centres that are using QUMAX

Can the PBS Survive the Current Distribution Methodology?

The year 1949 was notable. David Ben-Gurion and Harry S Truman began their march into history by taking up the leadership of their respective countries. A couple of notable politicians were born, namely Jose Ramos-Horta and Benjamin Netanyahu. The North Atlantic Treaty was signed, leading to N.A.T.O being born, and somewhat perversely, on the 1st of April Eire left the British Commonwealth to become the Republic of Ireland. And the PBS was born, being part of a grand plan initiated by Prime Minister Ben Chifley. The PBS managed to survive, unlike many of the Prime Minister’s health plans, which were ruled unconstitutional by the High Court.

E-scripts For All... But we are Forgetting all About Iatrogenesis

I want to talk about mistakes. The mistakes we have made to date in doing very little about e-scripts, the mistakes we may now make regarding the delivery of e-enabled prescriptions and the mistakes e-health systems will minimise in healthcare delivery and outcomes. These past two weeks have been a watershed for the (previous lack of) progress in matters to do with e-health and e-scripts in particular. We now have two declared e-scripts systems out on the street toting for business with apparently two more in the wings.

Undercover for Cancer

On 26 Feb this year, trailers were run every hour throughout the day advertising the channel nine current affair program ACA which was featuring a story about a “Queensland Medical Monster” - a Naturopath in Mackay who was claiming to cure cancer. As a member of the Australian Skeptics, a scientist and a Breast Cancer survivor, I had been recommended to ACA to be part of this story. This issue I’ll talk about my brief but successful career as an undercover reporter and why I believe some pharmacy owners may inadvertently be contributing to this type of quackery.

Gentlemen, Please………….Time Out!

No doubt Charlie Benrimoj hit a nerve the size of the cricket ball when he belted for six through the front window of the PGA recently, as he delivered a stinging condemnation during the Neil Naismith Commemorative Lecture. As Karalyn Huxhagen commented; “He only said what many are thinking”. I accept that the PGA money factory is well capable of employing the best expertise in their quest to secure a favorable agreement. However, that is no excuse to restrict the PSA, who are more than capable of making an intellectual contribution, despite the fact they don’t have two bob to rub together. And while there has been a declared “clarification” by the PSA, fallout is still occurring.

Truth or Consequences

About a year ago I wrote a column on the ABCs of selling. When I came to the letter T, there was no doubt what that word would be: Trust. It's the most important word in business. Trust is central to doing business with anyone. Without it, you have another word that begins with T: Trouble.

The Strategic Disarray in E-Health in Australia Goes from Bad to Worse!

Editor's Note: Dr David More is recognised as one of the health informatics industry experts and we are pleased to carry his column in i2P. For this month we have selected his comments in regard to a report prepared after a NEHTA/DoHA briefing on National E-Health Strategy. As he says, " I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work!

The Good Old Golden Rule

I’ve been thinking about contractors, physicians, presidents and the Quaids. A successful and respected contractor took his son under his wing to teach him the trade. The father’s philosophy was simple: Build each home as if you were building it for yourself. After several years, he assigned a project to the young man, informing him that for this one he was on his own. “I will see you when the house is finished,” he said. “Just remember, build it as if you were building it for yourself.” The son figured that without his father watching, he could cut a few corners and no one would ever know. So he bought substandard framing materials, lower-rated insulation, and thinner dry wall than his father would have used. Paying less for the materials, he pocketed the savings. When the house was completed, the father came to see the finished product. On the surface, everything seemed to match the quality of his own projects. “Looks great,” he said. “Congratulations! Now, I have some good news. You have built this house for you and your family. It's my gift to you for the work you’ve done with me over the years.”

Marketing Focus E-Zine - Differentiate and Win!

Differentiate … and win. There has never been a better time than the present for business leaders to identify, analyse and differentiate between customers and consumers. In families, business and government departments, the buying agent (purchase initiator) is seldom the actual or full consumer of the products or services which are ordered or secured. Therefore, differing purchase criteria can be and usually are applied to decision-making. For example, purchasing managers operate under differing performance parameters to plant managers, service division heads and research and development leaders. Likewise, mothers (the typical and prime buying agents for up to 70% of families) are stimulated and influenced by factors which are different to husbands, Generation Y and Generation X offspring and almost certainly to aging parents (particularly relevant if the post war baby boomer female head of the household finds herself as part of a “club sandwich” family scenario, in which she is squeezed between the varying demands of three generations). So, whom are we marketing to and trying to satisfy? In Australia, “Pester Power Purchases” which are those influenced by the pestering nature of young offspring demands are calculated to be worth some $80 billion per annum. Ignoring the difference between customers and consumers can be an expensive oversight.

Lack of Reduction in Buprenorphine Injection After Introduction of Co-Formulated Buprenorphine/Naloxone to the Malaysian Market. Bruce RD, Govindasamy S, Sylla L, Kamarulzaman A, Altice FL. Am J Drug Alcohol Abuse 2009 Feb 12:1

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. In this edition of i2P, Dr Byrne comments on an article from the American Journal of Drug Abuse titled "Lack of Reduction in Buprenorphine Injection After Introduction of Co-Formulated Buprenorphine/Naloxone to the Malaysian Market." Bruce RD, Govindasamy S, Sylla L, Kamarulzaman A, Altice FL. Am J Drug Alcohol Abuse 2009 Feb 12:1

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