Darragh O’Loughlin MPSI
IPU Secretary General
Irish Pharmaceutical Healthcare Association
RDS, Dublin: 26 November 2013
The IPU
• The voice of community pharmacy
• Negotiate
• Advocate
• Develop
• Support
• Defend
Challenging Times
• Austerity measures
• FEMPI Act
• Reduced consumer spending
• Falling medicine prices & increasing medicine shortages
• Increased competition: new players, new business models
Reference Pricing
• Reference pricing must be handled carefully
• Risk of destabilising market
• Exacerbation of existing supply chain pressures
• Impact on pharmacists will be significant
• Undermining patient adherence to medication therapy
through clumsily imposed substitution regime
Role of Pharmacy
• Accessible to patients
o Self-care – advice & information
o Signposting – other healthcare professionals
• Dispensing
o Core competence of pharmacists; essential for patient safety
o Efficient and cost-effective service provided for Government
• Introduction of new services
o Emergency Contraception
o Flu vaccination
Health Policy Shift
• Healthy Ireland Strategy
• Emphasis on keeping people healthier for longer
• Shift to Primary Care: treat at “lowest level of complexity”
• Opportunity for pharmacy
• Convenient, accessible, cost effective
Why Pharmacy?
• Issue for government
o Don’t yet have shortage of GPs, but waiting times lengthening
o DO have shortage of affordable, accessible primary healthcare
o Key political commitment remains unfulfilled
• Opportunity
o Government policy – “lowest level of complexity”
o ESRI report – emerging shortage of GPs
o B&A research – Affordability issues for middle-income earners
o Free GP care for all – looks increasingly difficult to deliver
o Pharmacists most accessible of all health professionals
Potential for Pharmacy
• Pharmacists are an under-utilised resource presently
• General Practitioner network overstretched
• Increased capacity required in Primary Care
• Pharmacists can support Healthy Ireland
o Health Promotion
o Health Screening
o New Medicines Service
o Medicine Use Reviews
o Chronic Disease Management
o Minor Ailments
International Experience
• UK
o New Medicines Service; Medicines Use Reviews; Pharmacist
prescribing; Minor Ailments Scheme; MHRA – proactive POM to
P switches
• USA
o Medication Therapy Management; Specialist roles e.g. diabetes
care, cardiac care; HMOs increasing pharmacist involvement in
patient care; FDA – considering massive POM to P shift
• Canada
o Smoking cessation; Renewal & adjustment of prescriptions;
Disease monitoring; Limited prescribing rights
Canadian solution
• Shortage of primary care physicians; patients couldn’t
access treatment
• Government eased problem by granting additional roles to
pharmacists, previously reserved for doctors
o Renewing a doctor’s prescription, but not beyond one year
o Modifying a doctor’s prescription with respect to form, dosage, quantity or
directions
o Substituting another medication from the same therapeutic subclass in the event of a
complete disruption in supply of the prescribed medication
o Administering a medication (not intravenous) for demonstration purposes
o Prescribing and interpreting laboratory analyses for monitoring, but not diagnostic,
purposes
o Prescribing a medication when no diagnosis is required, especially for preventive
purposes
The Future
• Financial position will remain tight given the economic
climate/public finances.
• Pharmacists based in the community are pivotal to the
delivery of health care policies – treating patients in the
community where the patient lives.
• Pharmacy profession will deliver a wider range of
healthcare services and become more innovative.
• Pharmacists & Pharma Industry must work together to
optimise medicine use and improve patient outcomes
The Challenge
• Need a more accessible, cost effective and integrated
health service which delivers for patients
• Implementing change difficult when resources are scarce
• New problems require new thinking
• Stakeholders working in partnership
• Shared goals + combined effort = mutual benefit
The End