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PGEU
La Farmacia en EuropaLa Farmacia en Europa
Filip BABYLONFilip BABYLONPresidentPresident
Pharmaceutical Group of the European UnionPharmaceutical Group of the European UnionRepresenting European Community PharmacistsRepresenting European Community Pharmacists
XVII National Pharmaceutical Congress Blbao 20th October 2010XVII National Pharmaceutical Congress Blbao 20th October 2010
PGEU
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AustriaBelgiumBulgariaCyprusCzech RepDenmarkFinlandFranceGermanyGreeceHungaryIrelandItalyLatviaLuxembourg
NetherlandsPolandPortugalRomaniaSlovakiaSloveniaSpainSwedenUnited KingdomCroatiaFYR MacedoniaNorwaySerbiaSwitzerlandTurkey
Pharmaceutical Group of European Union
Members: Professional Bodies & Pharmacists’ Associations
2010: 30 Countries2010: 30 Countries
PGEU
• 400.000 Community Pharmacists in Europe
• 160.000 Community Pharmacies in Europe
• 46 million citizens visit a pharmacy every day
~1300 2010
PGEU
11 december 2008 IFB4
PGEU
PGEU
PGEUWe have a winner
“Pharmacists help people get well, stay healthy, feel better, and save money. We help people safely use vaccines that prevent infections, medicines that cure diseases or prevent them from getting worse, and vitamins, supplements, or special foods to improve health and wellness.But most importantly, we are near your home, easy to talk to, good at answering questions, and care about you and your family.”
PGEURegulatory Change
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PGEURegulatory Change in Europe
• Strong tendencies toward liberalisation over the last 10 years e.g. Ireland, Norway, Hungary, Portugal, Italy, Sweden
• Now only Spain, France, Austria, Greece and Finland have all three traditional pillars of regulation – ownership rules, establishment rules and OTC monopoly.
• European Court Judgement on Ownership prevented ‘big bang’ liberalisation, but left room for change at national level – e.g. did not affect liberalisation in Sweden. Most recent country to liberalise ownership is Latvia (July 2010)
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PGEURegulatory Change in Europe
• Outcome of the Asturias case involving establishment rules in Spain strongly vindicates regulatory approach – European Commission arguments totally dismissed by the Court.
• Still strong advocacy from the EU Commission e.g. OTC monopoly
• However, still more than 80 per cent of EU pharmacies are pharmacist owned.
• Future arguments about ownership will be based on economics e.g. free ownership allows lower prices.
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PGEU
Spanish Pharmacy remains a model of how the needs of patients and health systems can be addressed within a regulated system.
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PGEU
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PGEU
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PGEUReductions in Payments & Margins since 2008
Reduction
Planned Reduction
N.A.
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PGEUReductions in Medicine Prices Since 2008
Reduction
Planned Reduction
N.A.
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PGEU
Pure Margin
Predominantly MarginPure fee
Balance of fee/Margin
Predominantly fee
Pharmacist remuneration systems in EU
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PGEUEconomic Change
The Problem of Falling Prices• There is a tendency both towards
increased generics use, and falling generic prices. Margin based and rebate systems stand to lose.
• At the same time in some countries more expensive medicines are being distributed through other channels.
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PGEUEconomic Change
The coming squeeze?• Many EU countries are suffering either
direct reductions in statutory remuneration schemes (e.g Ireland, Spain) or declines in remuneration due to falling prices (e.g. Netherlands, Finland).
• Pressure is short term (economic crisis) and long term (sustainability)
• Distribution increasingly seen as a source of unnecessary cost.
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PGEU
The pharmacist’s evolving roleThe pharmacist’s evolving role
redefining the roleredefining the role
Filip BABYLONFilip BABYLONPresidentPresident
Pharmaceutical Group of the European UnionPharmaceutical Group of the European UnionRepresenting European Community PharmacistsRepresenting European Community Pharmacists
PGEU
• The pharmacist must be an The pharmacist must be an active active counsellorcounsellor
• The responsibility is extending beyond The responsibility is extending beyond quality and conformity of products quality and conformity of products to a more to a more rational and optimal userational and optimal use
• The pharmacy is becoming a The pharmacy is becoming a healthcare healthcare centrecentre
• Relationship based on Relationship based on confidence and confidence and personal contactpersonal contact
the role of the the role of the pharmacistpharmacist
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PGEUSurvey Reader’s Digest
Trust in professions• Firefighters 92% • Airline pilots 88% • Pharmacists 85% • Nurses 84% • Doctors 82%
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PGEUPharmaceutical CarePharmaceutical Care
Shifting the pharmacist’s focus Shifting the pharmacist’s focus towards:towards:
• The quality of the dispensing activityThe quality of the dispensing activity(= counseling technique, scientific databases, patient records)(= counseling technique, scientific databases, patient records)
• The outcome of the treatmentThe outcome of the treatment(= registration of activities and results)(= registration of activities and results)
• The rational and optimal use of The rational and optimal use of medicationmedication(= choice of therapy and compliance)(= choice of therapy and compliance)
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PGEUShift the focus from product to
patient = professional service
PGEUServices provided by pharmacies
0 5 10 15 20 25
Vaccination
Other
Homecare services
Asthma management
Pregnancy test
Hypertension management
Medicines Use Review
Cholesterol measurement
Diabetes management
Glucose measurement
Repeat Dispensing
Emergency Contraception
Smoking Cessation
Blood pressure measurement
Disposal of waste medicines
Weight measurement
Night service
Dispensing Prescriptions
Ser
vice
Typ
e
Amount of countries providing service
YES
NO
Source: PGEU Database 2006
PGEUNew Possibilities
• Community Pharmacy as a locus of innovative health care services
• Self care and community care in an ageing society
• The challenge of improving adherence
• Connectivity and continuity within the health system
PGEUThe Challenge
• Reduce and prevent avoidable medication errors• Identify, manage and prevent drug-related problems• Improve adherence• Promote rational and safe medicines use• Early identify risk factors • Promote healthy lifestyles
WHAT SHOULD BE DONE?
AT WHAT PRICE? HOW TO VALUE IT?
WHO PAYS?
HOW TO SHARE THE INVESTMENT RISK?
HOW TO USE THE RETURN ON INVESTMENT?
PGEUConclusion
Re-engineer the profession in 3 steps:• Redefine the role of the pharmacist
not only in dispensing medicines but also as a healthcare service provider
• Implement quality through Good Implement quality through Good Pharmaceutical PracticePharmaceutical Practice
• Adapt the remuneration system Adapt the remuneration system going from margins to feesgoing from margins to fees
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PGEU
« In evolution it is not the strongest, themost aggressive or even the mostintelligent who are likely to survive.Rather, it is those most able to adapt tothe demands of environmental change. »
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PGEU
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www.pgeu.eu