The Pharmaceutical Journal Vol 267 No 7175 p732
24 November 2001

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Waste not, want not [more]
Work, work and more work [more]

Waste not, want not

How many pharmacists can put their hands on their hearts and say: "I have always finished every course of medicine that I have been prescribed, and I have never missed a day's dose." This week's cover story (p741) draws attention, once again, to the fact that just under 20 per cent of the total prescribing budget is effectively flushed away every year. We highlight some of the initiatives that pharmacists could be involved with to tackle this waste and improve compliance. Many people do not like taking a medicine for long periods and do not think it matters if they miss the odd dose and even stop it altogether, especially if the medicine disagrees with them or it does not seem to be making any difference. Statins are a case in point.

The juxtaposition of this article on waste with an article on whether or not we can afford to treat statins as the new aspirin (p740) is interesting. Research has shown that everyone at risk of heart disease would benefit from taking a statin, irrespective of their cholesterol level. Already, with the implementation of the National Service Framework for Coronary Heart Disease in England and Wales now in its second year, statins represent about 7 per cent of the total drugs bill — and that percentage is still rising.

Until there are services in place to ensure that patients are given proper and frequent guidance on the benefits of taking their medicines the waste is going to continue. What is surprising is that there seems to be so little evidence available to prove the point. Who has the evidence that pharmacy-led medicines management services are cost-effective? It should be easy to find and easily accessible by anyone interested in reducing waste. Let us hope that the Pharmaceutical Services Negotiating Committee's pilots into medicines management for patients with coronary heart disease will provide some of the answers.

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Work, work and more work

Once community pharmacists have recovered from the latest blow from the Government to the dispensing fee and the global sum (p732 and 739) they should write to their local Member of Parliament and the Minister with responsibility for pharmacy, Hazel Blears, to express their views. The Government has completely overlooked (or ignored) the increasing workload pharmacists face. How can pharmacists possibly be expected to develop new services and yet at the same time handle increasing numbers of prescriptions? It is not that it is unfair — it makes no sense.

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