Future impact on community pharmacies

Forefront

Date: 16 August 2017

Every year, the Pharmacy Guild and its sister organisations from seven English speaking countries meet informally to share their knowledge and experiences and to collaborate as community pharmacy leaders.

With this year's upcoming meeting in Sydney next month, community pharmacy leaders from Australia, New Zealand, the United Kingdom, Ireland, South Africa, Canada and the United States have been busy preparing by comparing trends and issues in their respective countries.

In spite of the significant differences in the economies, populations, geographies, cultures and health systems of the seven Pharmintercom countries, the trends and issues impacting community pharmacies are remarkably similar.

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.  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.

At the same time, governments are dealing with how to fund new expensive medicines for conditions like Hepatitis C, cancer and dementia as well as developing pricing and regulatory policies for 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.

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.

Pharmacists and their representatives continue to lobby for broadened scope of practice and funding for both dispensing and non-dispensing related services.

Some headway has been made with increased funding and scope of practice in areas such as administering vaccinations, down-scheduling of medicines from prescription only, paid medicine reviews, minor ailment programs, screening, and partial prescribing responsibilities.

At the same time, pharmacies are seeking to integrate with other health professionals to ensure that medicines related support is part of a more collaborative approach to patient care, but are meeting resistance from doctor organisations which see this as encroaching on their traditional areas of practice.

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.

Technologies are impacting virtually every aspect of pharmacy businesses, including online retailing, robotics, electronic prescriptions, patient apps, ‘Dr Google’, and shared health records.

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.

Broken down, these various trends and issues can be categorised under seven core drivers:

  1. Economic trends
  2. Health system trends
  3. Patient needs and preferences
  4. Industry structures
  5. Pharmacist practice
  6. Workforce
  7. Technology

As community pharmacy leaders contemplate the future, including in the run-up to the negotiation of the Seventh Community Pharmacy Agreement, each of these drivers requires in-depth consideration and conversation across our sector, as we work together to secure a sustainable future for community pharmacies and the pharmacist profession that delivers the best possible health outcomes for patients.

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Page last updated 30 August 2018