Core issues driving the future of pharmacy include the “corporatisation of healthcare,” funding cuts to pharmacy and the opioid epidemic
Ahead of the Guild’s annual meeting next month with sister organisations from around the world, Guild executive director David Quilty took a look at the key issues facing the sector, which he says are “remarkably similar” across the countries concerned.
That’s despite significant differences in the economies, populations, geographies, cultures and health systems across the Pharmintercom countries: Australia, New Zealand, the UK, Ireland, South Africa, Canada and the US.
He lists several key drivers, including:
- economic trends;
- health system trends;
- patient needs and preferences;
- industry structures;
- pharmacist practice;
- workforce; and
“Around the world, governments continue to deal with deficits and debt and see medicines and pharmacy as a means to save money rather than an investment in better health care,” Mr Quilty writes.
“Too often, policy makers perceive medicines as no different to any other item of commerce, not understanding the critical clinical role of pharmacist advice and counselling.
“As a result, pharmacies are struggling to cope with the financial impact of government funding cuts, with some being forced to reduce staff, services and opening hours.”
Meanwhile governments around the world need to examine how they will fund expensive new medicines, such as those for the treatment of hepatitis C, cancer and dementia, and handling the pricing and regulation of biosimilars.
“In turn, pharmacies and the broader pharmaceutical sector are increasing their focus on medicine adherence and compliance to demonstrate their value in improving patient health outcomes,” Mr Quilty writes.
He also warns that the “corporatisation of healthcare is increasingly encroaching upon pharmacy with large corporates seeking to dominate by vertically and horizontally integrating in the sector”.
“At the same time, medicine companies and distributors are entering into preferred and sometimes exclusive arrangements with certain pharmacies for the supply of specialised and other medicines.
“In the face of increased competition from large pharmacy groups, independent community pharmacies are responding by diversifying into patient specialties and by forming their own buying and marketing groups to achieve efficiencies of scale and scope.”
He says that opioids continue to be a major problem for pharmacy worldwide.
“Health systems are increasingly struggling with the abuse, misuse, diversion and unacceptably large number of deaths relating to prescription drugs – especially opioids – creating pressure for regulatory change and the need for ongoing vigilance by prescribers and dispensers.”
Mr Quilty also examines the way in which pharmacists are lobbying for a wider scope of practice, as well as funding, for dispensing and non-dispensing pharmacist services.
He says that there has been some headway made in vaccination services, downscheduling of some medicines from prescription-only, minor ailment programs, screening, partial prescribing and paid medicine reviews; meanwhile pharmacists are seeking to integrate with other health professionals to provide more collaborative support.
And technology is impacting “virtually every aspect of pharmacy business,” from online retailing to robotics and the issue of Dr Google.
“Finally, there is a growing number of examples of problems with drug shortages and interruptions of supply, brought on by price cuts, unforeseen demand and manufacturing problems.
“Around the world, it is vital that pharmacy leaders understand these trends and issues and their current and future impact on community pharmacy businesses, the pharmacy workforce and, most of all, patients.”