Last week, sister publication OTC.Newsflash reported that the College of General Practitioners and the Royal Pharmaceutical Society in England have proposed that pharmacists work in general practitioner “surgeries” (offices) to improve safety, patient care and waiting times for GP appointments. It brought to mind helping to care for my father-in-law, who had multiple health conditions that required a broad range of specialists prescribing Rx and OTC medications. Joe had four daughters, temporary visiting nurses and therapists, so coordinating his medication was a real challenge, in part because there were so many “helpers”.
The English proposal is meant to improve patient care by softening demands on a stable population of GPs treating an increasing number of patients. Apparently, there is an over-supply of pharmacists who train for five years — one year less than a doctor, one year more than a nurse.
Dr Maureen Baker, Chair of the RCGP, explained: “This isn’t about having a pharmacy premises within a surgery, but about making full use of the pharmacist’s clinical skills to help patients and the over-stretched GP workforce. Patients with long-term conditions such as asthma or diabetes and with complex medicine needs would particularly benefit from having a pharmacist to help navigate the conflicting and confusing information they sometimes receive about their treatment as they move between hospital and community care. Practice teams can also benefit from a pharmacist’s advice to help avoid medicine waste, improve the management of medicines and rationalise costs.”
OTCs will be in Action as pharmacists bring them into the office “surgery” setting by recommending effective, safe and affordable medicines to patents, while ensuring safe use of multiple treatments.
Matteo Renzi’s Italian government is plotting a fresh wave of liberalisation reform to help stimulate the floundering economy. The package includes measures for the banking, transport, energy and insurance industries, but also for pharmaceuticals. The bill proposes allowing all non-reimbursable (Class C) medicines with prescription to be sold outside pharmacies. The move echoes the Bersani Decree of 2006 – which made all non-prescription medicines available in the mass market – and could be understood as a continuation of Italy’s more recent liberalisation measures, including the Mario Monti government’s switch of 356 formerly Rx medicines to non-prescription but non-advertisable (SOP) status in 2012, with an additional 191 switched in March 2014.
If the bill is passed in spring this year, just as with all OTCs in Italy, the non-reimbursable (Class C) Rx medicines would still have to be sold under the supervision of the many hundreds of qualified pharmacists operating in drug stores across the country. These stores require the same level of security and medicine controls as pharmacies, so issues regarding consumer safety are minimal.
Of course, the hope for our industry is that increased distribution to the Rx medicines might eventually persuade the Italian government to switch more of these to non-prescription status. Even though the 500+ formats switched since 2012 remain with SOP status, they have provided some drive to a relatively stagnant OTC market. Categories significantly boosted by the switches include anti-fungals, wound healers and eye care.
But there’s a long way to go. The voice of the pharmacy lobby in Italy is a powerful one. Mario Monti’s government tried to push through the same measure in its early crisis days in December 2011, but met with a wave of protest, having to settle instead for the slightly softer mass Rx-to-SOP switch.
As expected, pharmacy-owners have again kicked up a tremendous fuss over the potential loss of earnings the new bill might bring, coupled in public statements with concerns relating to possible widespread medicine misuse and the all-too certain belief that the measures will bring no growth to the economy, with many citing that 7 years after the big Bersani decree, only around 10% of OTCs/SOPs are sold outside of pharmacies… So on that basis, the pharmacy-owners won’t lose too much. Way to shoot yourself in the foot. In fact industry sources put pharmacy earnings through Class C medicines – including OTCs and SOPs – at just over 15%, so if around 10% of this were to leave the pharmacy, it wouldn’t be a huge loss after all.
The bill is up for discussion at by the Government’s Council of Ministers meeting on 20th February 2015. Time to smear on the war paint…