The annual autumn conference of the Institute of Pharmacy Management International was this year held on November 5 as a joint meeting with the Australian Institute of Pharmacy Management, which had organised a 12-day visit to Britain combining conference sessions and fact-finding visits with social and sporting events
New drugs deemed inappropriate for National Health Service prescribing should be considered for pharmacy medicine status from the outset, instead of spending their first few years as prescription-only medicines, suggested Mrs Sheila Kelly (director, Proprietary Association of Great Britain) when she addressed the pharmacy management conference.
Mrs Kelly suggested that Relenza, the new influenza drug banned from NHS prescribing on the recommendation of the National Institute for Clinical Excellence, could be available without prescription, along with "lifestyle" drugs such as Xenical for obesity, Propecia for hair loss, Viagra for erectile dysfunction and the "morning after pill".
Whether or not this was possible, restrictions on NHS supply would encourage pharmaceutical companies to move medicines from POM to P status as soon as possible, and the Government would facilitate the switch because it needed to meet consumer demands. Pharmacies could be given diagnostic training as each new drug or category became available. Patient records could be introduced for switched drugs.
The work of NICE was just one of a number of drivers for self-medication, said Mrs Kelly. Another was NHS Direct, which would become nation-wide in 2000. Research from the pilots showed that over 40 per cent of the calls were about ailments and problems that could be self-treated. A new NHS Direct home health care guide would be published within a few months to be given to households to help educate people.
Looking at the current state of POM-to-P switches, Mrs Kelly said that more than 40 ingredients and 50 products had come on to the OTC market since the publication in 1992 of guidelines setting out the requirements for switches. However, there had been no new switches in 1999 and the past two years had seen analgesic pack sizes restricted and terfenadine and astemizole switched back to POM because of interaction problems.
The POM-to-P process had extended the scope of self-medication, with new OTC indications including arthritis, sleep disturbance, male pattern baldness, vaginal thrush, irritable bowel syndrome, and the prevention, as well as treatment, of indigestion and hayfever. But these were not big markets and there had not been a great impact on sales.
Part of the problem was pharmacists' limited opportunity to influence the choice of a medicine. Surveys had shown that the major influences on choice were previous experience and the recommendations of family and friends. Only one in 10 purchases was influenced by a pharmacist.
The good news was that 70 per cent of medicines were still bought in pharmacies, but pharmacists needed to work towards keeping those sales. They could do so by offering one-to-one information services, by providing confidential areas and by displaying and promoting pharmacy medicines. The profession could promote the availability of the pharmacist and launch specific ailment campaigns.
Other subjects discussed include:
The pharmacist as vending machine
Australia's community pharmacy accreditation system
Keeping it simple in improving business performance