The Pharmaceutical Journal
Vol 268 No 7199 p705-712
25 May 2002

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Remuneration cannot be linked to professional decision making

Remuneration of pharmacy services needs to be addressed if the provision of services by pharmacists continues to expand, according to Trevor Jones, director general, Association of the British Pharmaceutical Industry. "Decision making [in terms of pharmacist prescribing] cannot be linked to remuneration," he said.

Professor Jones was speaking at a media lunch organised by the ABPI to raise and address issues of concern to the association. He expressed concern about pharmacists taking on roles as prescribers: "We would be most concerned if, as part of [medicines management], the pharmacist could change the medicine — that would be hugely dangerous because pharmacists don't have access to full patient records."

He added: "My worry would be the motivation to change [a prescribed drug]. If the professional judgement is that there is a need for a change — fine. But, is it likely that pharmacists would uprate a medicine to a more expensive drug?"

Professor Jones went on to say that in the case of "high-tech" interventions, there would be circumstances in the future when there was no need for a doctor, a pharmacist or a wholesaler.

He proposed that if patients could get a diagnosis from a distant test then the company providing that diagnosis could also deliver the high-tech medicine to treat the disease. "There are elements of medicines management that are high-tech which can use modern technology that could deliver what patients want far quicker than current systems. We should encourage that if it saves money for the health service," he said.

Andrew Curl, deputy director general of the ABPI told The Journal that the association wants to develop a much more constructive relationship with pharmacists. In terms of reclassifying medicines, Mr Curl said that the APBI had some concerns about the new process (PJ, 4 May, p598 and 607). "The ABPI is all for wider patient access to medicines but patient safety should be paramount."

He said that it should be the responsibility of the product licence holder to determine when and if a switch is made. He added that patients must not be penalised financially if a product is reclassified. "If a prescription only medicine is moved to pharmacy medicine status and then delisted, exempt patients will have to pay for the product in the pharmacy that they previously received free of charge."

He also said the ABPI had concerns over some of the drugs included in the strategy document for proposed POM to P switches (PJ, 2 February, p131). He cited the example of statins, which are included in the strategy document. "Recently, one major product was removed from prescribing because of a safety issue. We need to be sure that the safety profile is good enough for a drug to be sold over the counter."