JANUARY 2017 - At the latest Pharmacy Forum hosted by CFP, attendees got some sobering insights into what may lie ahead for Canada’s pharmacists. “I’m here to scare you all,” said guest speaker Mark Burdon, a community pharmacist and member of the Pharmaceutical Services Negotiating Committee (PSNC) in the United Kingdom, who gave highlights of his own country’s struggles in dealing with government and securing compensation for pharmacy services. He noted that his ultimate “pharmageddon”—the commoditization of pharmacy—wasn’t far-fetched either.
With 50% of scripts now electronically submitted and the move to a 90-day medication supply, Burdon pointed to the fact that “distance-selling” pharmacies have become the cheaper option for distribution. “That pushes us down a central fill system,” he said, adding that the UK’s Chief Pharmaceutical Officer believes that two-thirds of all medicines could be dispensed by automated warehouses. “My message to you is that splitting service and supply is very dangerous.”
Further stagnating the progress of UK pharmacists are physicians unwilling to give up turf. “We get a lot of GP opposition, and they even put up posters saying if you get your flu shot through a pharmacy, you’re depriving this surgeon of income,” he said. “We really need unity across the healthcare sector.”
Burdon talked about pharmacy’s tenuous relationship with government, noting a lack of communication between the sectors and government’s focus on spending cuts at the expense of pharmacy services. Case in point, a new pharmacy contract was announced in 2005 that promised “market liberation,” but an open letter to the PSNC in 2015 fixated on improving efficiencies by cutting $170 million pounds from community pharmacy in 2016/17. “We were all wondering why government had suddenly changed its position and moved backward to demolish community pharmacy,” he said. “Clearly, pharmacy was viewed as old-fashioned, slow and clunky.”
Highlights of that letter included the fact that there were more pharmacies than necessary to maintain good access, and that large automated dispensing could provide opportunities for efficiencies. “We had home delivery but the plan from government was that every patient was offered to have their medications dispensed by warehouses,” said Burdon.
Fortunately, it’s not all gloom and doom for community pharmacy in the UK. A report conducted by PwC provided some compelling data on the cost-savings generated by pharmacists’ interventions. “For example, the value of [pharmacy] services in preventing death is huge, at two million pounds,” he said. “We have to build on PwC’s work and be a lot more proactive.”
Adding to that is the fact that the PSNC undertook a successful national campaign to get the public on side and its petition secured 2.2 million signatures, more than any other health petition. “There is real potential for far greater use of our community pharmacies and [most of us] want to have clinically focused community services integrated into primary care,” he said.
One key piece of advice Burdon emphasized at the Pharmacy Forum: keep a good record of evidence-based data that could be shared easily and often with key healthcare decision makers. “[In the UK] we have lost a difficult battle, but we cannot give up on the war,” he said.