The proposed Minor Ailments Scheme based in pharmacy is just “a push by the pharmaceutical industry and pharmacy business to increase drug sales under the guise of health innovation,” according to a prominent GP.
Writing in MJA Insight, Evan Ackermann, a GP at the University Medical Centre, Southern Cross University, Gold Coast, Queensland, and the chair of the Royal Australian College of General Practitioners National Standing Committee – Quality Care, says that while a formal trial to investigate the feasibility of such a Scheme is necessary, a trial should also examine whether further regulatory measures are needed to protect patients.
“Unless integrity within the pharmacy industry is improved, MAS programs will simply become another mechanism to increase drug use in the community,” Dr Ackermann says.
He says that despite the availability of a Minor Ailments Scheme in other countries, such as the UK and Canada, for several years there is a dearth of good quality evidence supporting them.
“A recent systematic review has shown that the quality of reporting in MAS evaluations is often poor, and the assessment of bias is often difficult,” he writes.
“The authors concluded that there was some positive evidence for MAS programs, but that results needed to be interpreted with caution and may be unique to the UK system.
“Ominously, the broader issue of drug utilisation was not considered in any of the evaluations; for example, deregulating the use of the antibiotic chloramphenicol in the UK led to a 48% increase in its use through substantial prescribing by pharmacists.”
He says that using an MAS to alleviate pressure caused by lack of access to GPs is not necessary as there is evidence that GP access is not a problem.
Dr Ackermann also raised the “Coke and fries” controversy of several years ago, where Blackmores and the Pharmacy Guild had discussed offering complementary medicines with routine prescrptions.
“The relationships between these groups in Australia are not well known, and certainly not well studied,” he writes.
He suggests that ASMI’s support for increasing consumer self-care is motivated by profit and questions the motives of courses for pharmacists aimed at increasing S2 and S3 sales.
“OTC drug sales are big business in Australia, but OTC medicine misuse is also a problem well known in the literature,” he writes.