Home > Daily News archives (2001)

June 2001

CPP loses e-mail facility (June 27)

The College of Pharmacy Practice has lost its e-mail facility following the collapse of its internet service provider, which is now in liquidation.

All messages e-mailed to the CPP within the past week have been lost. The college asks those who have recently sent e-mails to contact it again by telephone (024 766 2400) or fax (024 766 3069).

Until the e-mail address is restored, all further contact should be by telephone, fax or post

College of Pharmacy Practice
University of Warwick Science Park
Barclays Venture Centre
Sir William Lyons Road
Coventry CV4 7EZ)

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Three new members for Society’s Scottish Executive (June 25 updated)

The annual election of six members of the Royal Pharmaceutical Society’s Scottish Executive has resulted in three changes, with Elizabeth Grant, Harry McQuillan and Margaret Ryan all being elected for the first time. The other three vacancies have been filled by the re-election of Alister MacLaren, Pat Murray and Andrew Taylor. The three new executive members replace James Bunney, Elizabeth McConechy and Graeme Millar, none of whom sought re-election.

TAYLOR, Andrew J.	389
MURRAY, Pat	373
MCQUILLAN, Harry	343
GRANT, Elizabeth M.	342
RYAN, Margaret G. B.	341
MACLAREN, Alister	339
DUNCAN, John I. S.	326
HICKEY, Maurice	314

The number of voting papers issued was 3,974. Of these 738 were returned, of which seven were incomplete and none was invalid.

On June 20, at the new executive’s first meeting, the executive unanimously elected Alison Strath to serve as chairman for a second year. David Thomson was unanimously re-elected as vice-chairman.

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Scots to cut NHS administration (June 25)

National Health Service administration in Scotland is to be reduced by replacing 43 health boards and trusts with 15 health boards by September 30. The move is part of a general reduction in public bodies announced by the Scottish Executive on June 21.

The Scottish health minister, Susan Deacon said: “By having just one identifiable decision-making body for each NHS area we are doing much more than just streamlining bureaucracy — we are rebuilding the NHS as a truly national health service.”

She said that creating the new boards will clarify responsibility, increase accountability, streamline bureaucracy, improve planning, and integrate local decision-making.

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Pharmaceutical Care Awards winners (June 25)

The winners of the Pharmaceutical Care Awards 2000, organised by The Pharmaceutical Journal and sponsored by GlaxoSmithKline, were announced at a presentation held at the Savoy Hotel, London, on June 22, 2001.

Shared care The winners were Kouser Chaudry and colleagues from Parkside Health NHS Trust, Willesden, London, with a project entitled “Exploring the benefits of a pharmacist in a community rehabilitation team”. The runners-up were Karen Hassell and colleagues from the University of Manchester, Sefton Health Authority and Moore Street Surgery, Liverpool, with a project entitled “Minor ailment management at the community pharmacy: a question of access”.

Community care The winners were Harry McQuillan and colleagues from Lothian Primary Care NHS Trust for a project describing “A community pharmacy palliative care network”. The runners-up were Andrew Radley and colleagues from Olegmor Surgery, Dunkeld, and Tayside Primary Care NHS Trust for a project entitled “A pharmaceutical model scheme to support social services clients with medication problems in Perth and Kinross”.

Hospital care The winners were Karen Reid and colleagues from Lothian University Hospitals NHS Trust for their project on “The development and implementation of performance monitoring system for clinical pharmacy”. The runners-up were Labib Tadros and colleagues from Darlington Memorial Hospital, South Durham Health Care NHS Trust for their project on “The pharmacist-led type II diabetic clinic: a new delivery care system for pharmacists”.

Full details of all the projects and the awards presentation will be in the June 30 issue of The Pharmaceutical Journal.

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GW Pharmaceuticals raises £25m for cannabis research (June 22)

GW Pharmaceuticals, the company created to develop new medicines from cannabis, has raised £25m by selling shares and seeking a listing on the alternative investment market.

The company was seeking £16m, but the share offer was six-times oversubscribed and the shares were sold at the top of the expected price range. The placing gives the company a market capitalisation of £175m, making its founder, Dr Geoffrey Guy worth £40m.

The money raised is to be used to pay for late-stage clinical trials of cannabis-based products to treat multiple sclerosis and cancer pain. It will also fund expansion of the company’s cultivation and production facilities in anticipation of the commercial launch of its products.

Information on GW Pharmaceuticals can be found on the internet at www.gwpharm.com.

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Society to sell Medicines Testing Laboratory for £550,000 (June 20)

The Royal Pharmaceutical Society is to dispose of its Medicines Testing Laboratory in a cash and share deal worth more than half a million pounds.

The Society exchanged contracts with Tepnel Life Sciences Plc on June 14. Completion of the £550,000 deal depends on Tepnel raising £8m on the Alternative Investment Market for the development of its core strategy, of which the MTL purchase is a major part. The target date for this process is July 16.

The Society says that the deal is good news for the MTL, “since it will provide funding, property and ambitious synergistic partners to drive the business forward, including a move into appropriate facilities”.

The Society set up the MTL in 1972, principally to provide an independent analytical service to the Department of Health’s medicines inspectorate. More recently it has also offered analytical and consultancy services to clients on a commercial basis. The MTL is based in Edinburgh and has a staff of about 40.

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Society offers professional development awards (June 20)

The Royal Pharmaceutical Society is offering further financial awards to support professional development initiatives by pharmacy development groups (PDGs) and similar local bodies across England and Wales.

Awards of up to £500 will be made to support development of the infrastructure of the PDG. Awards may be used, for example, to help with administration costs or room hire costs for an initial meeting or to assist with the acquisition of a fax machine or an e-mail address.

Application forms and information about eligibility for awards can be obtained from Anne Adams, the Society’s professional development manager (tel 0115 939 6465; e-mail aadams@rpsgb.org.uk). The closing date for applications is July 31.

In Scotland, the Society’s financial support for professional development in 2001 is to be used to finance a second conference for the promotion of pharmaceutical input into local health care co-operatives.

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New minister responsible for pharmacy (June 15)

Hazel Blears, the newly appointed parliamentary under-secretary of state at the Department of Health is the minister responsible for community pharmacy in the new government.

Lord Hunt retains his responsibility for medicines.

The full list of responsibilities is:

Alan Milburn, Secretary of State for Health
Overall responsibility for the work of the department with particular responsibility for finance and resources, the private finance initiative and strategic communications.

John Hutton, Minister of State for Health

• The NHS and delivery
• NHS human resources including the workforce taskforce
• Access to services including the waiting and access taskforce
• Commissioning
• Capital, including the capital and capacity task force
• Primary care services
• NHS treatment for asylum seekers
• Equality
• London regional office

Jacqui Smith, minister of state

• Social care, long term care, disability and mental health
• Long term care for the elderly, including the older people’s taskforce and nursing and residential care
• Intermediate Care
• Children’s social care
• General personal social services
• Care trusts
• Mental health services, including the mental health taskforce
• Prison health services
• Long term conditions, including the long term conditions national service framework, diabetes and renal services
• Disability services, including community equipment services
• Northern and Yorkshire region

Lord Hunt, parliamentary under-secretary of state

• Performance and quality
• NHS performance management, including the performance taskforce
• Clinical quality, including the quality taskforce
• Medicines and medical devices
• Genetics and biotechnology
• R&D, statistics, IT
• Executive agency management
• Departmental management
• Eastern and North West regions

Yvette Cooper MP, parliamentary under-secretary of state for public health

• Public health
• Public health protection and prevention
• Cancer, including the cancer taskforce
• Coronary heart disease and stroke, including the CHD taskforce
• Tobacco
• Health inequalities including the inequalities taskforce
• Embryology
• Maternity
• Sure Start
• Children’s health, including the children’s taskforce
• Sexual health and HIV, AIDS
• Blood
• Teenage pregnancy
• International health business
• Food Standards Agency
• BSE and vCJD
• Complementary and alternative medicine
• Trent and West Midlands regions

Hazel Blears, parliamentary under-secretary of state for health

• Emergency care and public involvement
• Emergency care including winter planning and NHS Direct
• Patients focus including community health councils, complaints, clinical negligence, organ retention, the hospital environment and the patient and public involvement taskforce
• Health action zones
• Pharmacy services
• Optical services
• Dental services/flouridation
• Drugs/alcohol/crime
• Reconfiguration policy
• NHS Plus/occupational health
• Appointments
• Road Traffic Act
• Defence Medical Services
• South East and South West regions

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GSK to cut UK manufacturing sites (June 14)

Over 1,000 jobs in pharmaceutical manufacturing in the United Kingdom are to be lost over the next three years as GlaxoSmithKline Plc restructures its prescription and consumer medicine manufacturing operations.

The company announced on June 14 that it is to close its site at Speke, Liverpool, over the next three years with the loss of up to 500 jobs. The site predominantly manufactures CFC-containing asthma inhalers which are being phased out under the 1995 Montreal protocol on ozone-depleting substances. A further 400 jobs cuts are planned at GSK’s Barnard Castle site in County Durham. The site currently employs around 1,500 people and will remain one of the company’s largest manufacturing sites in the world. Around 170 jobs will be lost in Devon over the next two years when GSK closes a consumer products manufacturing plant at Plymouth formerly owned by Block Drug Inc, a company which was taken over by SmithKline Beecham shortly before its merger with Glaxo Wellcome.

GlaxoSmithKline is also proposing to sell its bulk active pharmaceutical ingredients manufacturing site at Montrose, Angus, in Scotland. The site will be sold as a going concern with a number of GSK products continuing to be manufactured under long-term contract. The site employs 720 people.

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MRC supports pharmaceutical care trial (June 13)

Nearly £750,000 has been allocated by the Medical Research Council from its primary care research fund to support a randomised clinical trial of pharmaceutical care for older people delivered through community pharmacies in East Yorkshire and Hull. Four primary care trusts in the area will provide a further £150,000 for the 21-month trial.

Each trust will be randomised and patients identified by GPs will receive pharmaceutical care from community pharmacists, either in pharmacies or through home visits, for one year. At other times they will receive a standard pharmaceutical service of dispensing and advice.

The project, entitled Offering shared care prescribing: research in East Yorkshire (OSPREY), will be run by Dr Ian Wong, senior lecturer in pharmacy practice, University of Bradford. Recruitment of GPs and pharmacists will start in October and patient recruitment in the new year.

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Medicine sales rise after price cuts (June 12)

Cuts of up to 40 per cent in the prices charged by supermarkets for 12 tablet packs of Nurofen 200mg have generated increased sales of the product. So great are the additional sales that independent community pharmacists have lost 29 per cent of their market share in the first week after the end of resale price maintenance even though the actual volume of sales in pharmacies has remained virtually unchanged.

Market researcher IMS Health says that independent pharmacies which kept their price unchanged saw their market share fall from 55 per cent to 39 per cent, while national multiple pharmacy companies other than Superdrug and Boots saw their market share fall by only 1 per cent.

The 12 tablet pack of Nurofen was the most heavily discounted medicine in supermarkets, with prices cut by more than 40 per cent in comparison to the previously enforced price. The price of 16 tablet packs was reduced by 26 per cent. Before the lifting of RPM, supermarkets held a 39 per cent share of the market for the product, but held 93 per cent of the market in 16 tablet packs. After the abolition of RPM, their share of the 12 tablet pack market rose from 17 per cent to 56 per cent.

IMS says: “The supermarkets appear to be giving greater reductions in prices for lines for which they have a lower market share where they can potentially attract the most business from pharmacies.”

The greatest price reductions overall were in grocers that did not have pharmacies, where price cuts of at least 15 per cent were implemented. Grocers with pharmacies cut prices by at least 10 per cent.

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Regional medicines information website launched (June 11)

The Trent and West Midlands regional medicines information services have set up a website (www.ukmicentral.nhs.uk) for hospital, community and primary care pharmacists. The site will form part of a national medicines information service to be launched in the autumn which will incorporate other regional information services and the existing national site (www.ukdipg.org.uk).

The Trent and West Midlands site includes medicines information and prescribing bulletins, new drug evaluations, cost comparisons, a clinical trials register and formulary support information. There is an area dedicated to information on drugs in lactation, the regional speciality of the two medicines information services.

Most of the information will open to all users, but a small amount may be restricted either health care professionals or to health care professionals in the Trent and West Midlands regions, particularly information relating to local primary or secondary care organisations. Authorisation for this will be managed by the Virtual Health Network, which supports the Association of the British Pharmaceutical Industry’s electronic medicines compendium.

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PSNC announces medicines management pilot sites (June 11)

There are to be nine pilot sites for the Pharmaceutical Services Negotiating Committee’s cardiac medicines management scheme. The project has at least £1.5m of government funding.

The nine locations chosen are

1. Riverside primary care collaborative, North Tyneside primary care trust
2. Shipley and Baildon — Bradford North PCT, Yorkshire
3. East Salford — Salford PCT, Manchester
4. Nantwich — Crewe and district PCT, Cheshire
5. Lichfield — Burntwood, Lichfield and Tamworth PCT, Staffordshire
6. Hatherton Rushall, Aldridge and Walsall Wood — Walsall East primary care group, West Midlands
7. Aylesbury locality — North Southwark PCG, London
8. Charles Dickens, Fratton, Havelock and St Thomas wards — Portsmouth City PCT, Hampshire
9. The Adam Practice — Poole Central and North PCT, Dorset

The nine successful bids have been chosen from 33 submissions, all of which have been described as good.

John Dixon, the PSNC’s project manager said: “Credit is due to all the people who submitted bids, we could have worked with any of them. They were all good.” Mr Dixon said that the researchers had chosen a good set of representative locations from the 33 bids. “They are a good spread of people who are typical of the whole country.”

The nine locations chosen cover almost 50 medical practices with 180 doctors, and 80 community pharmacies.

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Pharmacist MP holds seat (June 8)

Sandra Gidley, the pharmacist Member of Parliament for Romsey, has been returned to Westminster in the June 7 general election.

The Conservatives failed to regain the seat they lost to her in the by-election last year, when she overturned a Tory majority of 8,585 to win by 3,311 votes for the Liberal Democrats. On Thursday, Mrs Gidley held off the Tory challenge to win by a reduced margin of 2,370 votes.

Fighting his second general election in Worcestershire West, pharmacist Mike Hadley was runner-up for the Liberal Democrats with 15,223 votes. He was 5,374 votes adrift of the Tory winner’s 20,597.

In Brent East, Ashwin Tanna, standing for the UK Independence Party, received 188 votes. Labour’s candidate held the seat with 18,325 votes. Mr Tanna is a member of the Royal Pharmaceutical Society’s Council.

Archy Kirkwood, a pharmacy graduate who never undertook his preregistration training, has retained the Roxburgh and Berwickshire seat he has held for the LibDems since 1983.

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Marshall Davies elected President of the Society (June 6)

The Council of the Royal Pharmaceutical Society has elected Marshall Davies to succeed Christine Glover as President of the Society. Gill Hawksworth follows Mr Davies into the role of Vice-President and David Allen has been re-elected Treasurer. The election took place at a meeting of the Council on June 6.

In the election of the President. Mr Davies was the sole candidate.

In the election of the Vice-President, Alan Nathan and Ashwin Tanna were also candidates. In a first ballot, Dr Hawksworth gained 11 votes, Mr Nathan seven and Mr Tanna four. Because no candidate had more than half the votes, the two with the highest voting figures went forward to a second election, which Dr Hawksworth won by 12 votes to Mr Nathan’s 10.

In his re-election as Treasurer, David Allen beat off a challenge from Hassan Argomandkhah by 15 votes to seven.

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Leeds teaching hospitals contract Pharmacy2U to deliver medicines

The Leeds Teaching Hospitals NHS trust has given the Pharmacy2U online pharmacy company a two-year contract to supply medicines.

Pharmacy2U won the contract after a tendering exercise and will deliver medicines to a number of points within the trust and also to patients’ homes. The service is currently concentrated on two clinical areas — renal and HIV therapy — but may be expanded. Medicines for outpatients are to be delivered to their homes, their places of work or any convenient location chosen by the patient.

The trust and Pharmacy2U are also to develop an electronic prescribing link from the hospital to the online pharmacy. There is also a possibility that the dispensing service will be extended to include discharge medication.

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EHC controversy in Spain (June 5)

The launch of levonorgestrel in Spain as an emergency contraceptive has provoked controversy in the country, with complaints that the price is excessive and ethical objections from some pharmacists.

There was widespread acclaim when the product was approved in March, but this changed when health minister Celia Villalobos announced that the state health service would not pay for the treatment. Instead, people would have to buy it using private prescriptions.

On May 9, Ms Villalobos ruled out the possibility that the state health system was going to pay for the drug, saying that it was not a priority issue, given the country’s huge drugs bill.

But taking advantage of its local powers concerning health, on May 15 the Andalusian regional government made the product available free of charge and without prescription to women who requested it following unprotected intercourse. Free availability did not extend to pharmacies. The Andalusian health department also ruled that all pharmacies must supply levonorgestrel when requested by prescription.

The order follows public statements by several Spanish pharmacists and a 400 member association of Catholic pharmacists, saying that they will not supply levonorgestrel because of ethical objections. Spanish bishops have been asking doctors and pharmacists to invoke a conscientious objection to emergency contraception.

Spanish law permits doctors to refuse to carry out abortions, but medicines legislation compels pharmacists to dispense all prescribed medicines. Pharmacists have been reminded of this and warned by both the health ministry and the president of the General Council of Pharmaceutical Colleges, Pedro Capilla.
— Xavier Bosch

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University pharmacy applications fall (June 4)

Applications to study pharmacy at United Kingdom universities have fallen by 12.9 per cent.

A total of 14,875 applications to study pharmacy were made this year. The actual number of pharmacy applicants is much lower because the figures represent the fact that students apply to more than one institution.

The decline in applications for a pharmacy degree, which remains a popular course, stands in stark contrast to an 11.5 per cent increase in applications to train as nurses. Other popular subjects include computer science (up 11.1 per cent), humanities with arts (up 10.2 per cent), physical sciences (up 12.3 per cent) and medical subjects other than preclinical medicine, dentistry and veterinary science (down 11.9 per cent). Dentistry applications were down by 27.5 per cent and veterinary applications by 26.8 per cent. Preclinical medicine applications fell by 1.1 per cent.

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Society’s Council censured by SGM (June 4)

The Royal Pharmaceutical Society’s Council has been censured by the special general meeting of the Society held on June 3.

After an earlier motion of no confidence in the Council had been lost, Philip Walton moved: “This meeting censures the Council for the process used to appoint the editor of The Pharmaceutical Journal”. The motion was seconded by Maurice Hickey. After debate, the motion was carried by 21 votes to 16.

The meeting had previously rejected by 23 votes to 14 a motion of no confidence in the elected members of the Council for offering the editor’s post to a non-pharmacist. The motion had been proposed by Ashwin Tanna and seconded by Robert Blyth.

The one-and-a-half hour meeting was attended by about 60 members.

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Asda launches diabetes initiative (June 1)

Asda Pharmacy is to run an in-store disease-led marketing campaign on diabetes during diabetes week (June 10 to 16).

During the week, in-store announcements will be made telling customers that it is diabetes week and suggesting that they get advice from the store pharmacist. Leaflets giving information on food and drink, and other products that are more suitable for people with diabetes, will be available.

In addition, some stores are to hold booked shop tours, led by dietitians, which will be used to show people what foods are better for them eat and to emphasise the importance of eating five portions of fruit or vegetables a day.

Jeremy Armes, pharmacy buyer for Asda said: “In the United Sates, Wal-Mart does this sort of thing a great deal. It’s about getting our pharmacists recognised as a reputable source of information by diabetic patients.”

Asda believes that diabetics are important customers for both its pharmacy and grocery products. This is because US figures show that diabetics spend 10 times more on health care than the average patient. Also, they tend to shop from predetermined lists, which makes them very loyal customers.

Mr Armes added that Asda had been very successful in selling Roche blood glucose meters and that this had had the knock-on effect of increasing turnover of insulin prescriptions by 300 per cent.

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May 2001

Numark to trial open display of P medicines (May 30)

Numark Ltd is to undertake a trial of allowing customers to self-select both pharmacy and general sale list medicines at a concept store.

Speaking at Numark's conference in Boston, United States on May 29, David Wood, deputy managing director, said that the company's research had shown that its customers preferred to buy medicines on self-selection. Numark believed that this was possible for P medicines so long as professional control over the sales was retained.

At the concept store, Landsdales Pharmacy, West Wycombe, P medicines are displayed alongside relevant GSL products. All P medicines have red price labels applied. Under Numark's protocol, which has been approved by the Royal Pharmaceutical Society, all sales of P medicines must be carried out by the pharmacist or trained medicine counter assistants. Signs warn customers that they will be asked about the medicines they are buying and that sales may be refused in some cases. Electronic point of sale equipment prompts staff to counsel customers. The concept pharmacy has only one till and the medicines are displayed adjacent to this. Certain newly reclassified medicines or those open to abuse are not on open display.

Mr Wood said that up to four pharmacies would trial open display. A full report of the conference will be included in the June 9 issue of The Journal.

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Needle-free injectors get boost (May 22)

Two companies producing needle-free injection systems have signed agreements to allow commercial manufacturing of their products to begin. Weston Medical Group Plc will see a full-scale drug filling and assembly line for its Intraject formulation installed at Patheon UK Ltd's facilities at Swindon, Wiltshire. Commercial volumes of the liquid-filled devices will be available by the end of 2002. Weston Medical has signed licensing agreements with Roche and GlaxoSmithKline for the technology.

PowderJect Pharmaceuticals Plc has signed a deal with BOC Gases Ltd to establish a full-scale production facility for the 75mm-long helium microcylinders which power its PowderJect dry-powder injector. The facility will be at BOC's plant at Leatherhead, Surrey. It will have four production lines each capable of welding, filling and sealing 100 microcylinders per minute. Installation will start in November. Last year, PowderJect Pharmaceuticals acquired the Evans Vaccines business formerly owned by Medeva Plc.

Police launch National Association of Chemist Inspection Officers (May 22)

A new organisation, launched to co-ordinate the work of police officers involved in chemist inspection duties across Britain, staged its first national seminar at West Mercia Constabulary Headquarters this month.

The National Association of Chemist Inspection Officers was formed under the auspices of the Association of Chief Police Officers drugs subcommittee, chaired by the West Mercia chief constable, Peter Hampson.

The seminar attracted representatives of 43 forces, including those for Jersey, Guernsey and the Isle of Man. Participants also attended from the Home Office drugs inspectorate, the Royal Pharmaceutical Society and the Department of Health in Northern Ireland.

The subjects covered included the destruction of out-of-date Controlled Drugs, electronic recording of data, possible changes in legislation in light of the Shipman inquiry and the future role of the association, including the setting up of regional areas and co-ordinators for the association.

The association is about to embark on the establishment of its own section on the European Police Internet (EpiCentre) which can be used securely by all police personnel and will act as a notice board to post details of current trends and problems, and of association activities.

National seminars are to take place every six months, with three-monthly regional meetings.

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Society issues advice on the price-promotion of medicines (May 18)

The Royal Pharmaceutical Society has issued guidance to pharmacists on the promotion of medicines in the light of the abolition of resale price maintenance.

The guidance says that price promotions, special offers and three-for-two offers are acceptable for general sale list medicines so that pharmacies can compete on equal terms with non-pharmacy outlets which cannot be constrained by professional ethics.

The position is more complicated where pharmacy medicines are concerned. The Society says that pharmacists must consider the case for individual products on their merits. Simple price promotions are acceptable, as are three-for-two type offers where pack sizes are small and people would legitimately be taking the medicine for an extended period of time, such as antihistamines.

“The challenge for pharmacists is going to be deciding where to draw the line,” The Society says. “Pharmacist owners and superintendents must be satisfied that promotions for P medicines are acceptable and that they do not seek to persuade customers to obtain medicines which are not wanted or in quantities which are substantially in excess of those wanted.”

The full guidance is available from the Society's website as a PDF file. To download it, click here.

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OFT to seek costs from CPAG (May 17)

The Office of Fair Trading is to try to recover from the Community Pharmacy Action Group some of its legal costs in bringing resale price maintenance to an end.

This is despite a heavy hint from the judge in the case that an application for costs would be unlikely to succeed.

The Restrictive Practices Court, which heard the case, is bound by statute not to award costs against any party appearing before it unless their behaviour in the case has been unreasonable. When the CPAG withdrew its opposition to the OFT's application for discharge of the 1970 order which allowed RPM on medicines, the judge warned the OFT that this was a high hurdle to overcome. He added that he would not consider the director-general of fair trading to be in dereliction of his public duty if he decided not to seek costs.

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Resale price maintenance ends (May 15)

Resale price maintenance on medicines is to end.

The Community Pharmacy Action Group, acting on the advice of its counsel, decided to withdraw its opposition to the Director General of Fair Trading's application to the Restrictive Practices Court for a ruling that RPM is no longer in the public interest.

Mr Justice Buckley, the judge hearing the case with two lay assessors, said on May 15 that there was insufficient proof that a substantial number of independent community pharmacies would close or that the range of products available to the public would be significantly reduced if RPM was removed.

CPAG's chairman and community pharmacist, David Sharpe said that this outcome was a devastating blow to Britain's network of community pharmacies.

“This has been a very difficult decision for CPAG because we continue to believe that we have a strong case and that many pharmacists rely on RPM to stay in business. However, having been given the clear indication that we are unlikely to win, it is in no one's interest to continue incurring further costs.”

He added: “Many pharmacists will simply not be able to survive, given the buying power and aggressive pricing tactics of the supermarkets. It's a sad day for Britain as this outcome threatens yet another community service on the high street. The potential losers here are the elderly, disabled and young mothers who rely heavily on the free advice and range of services offered by the local pharmacist. We'll fight on to provide these vital services and hope the public will remain loyal to their community pharmacist.”

Although it may be some time before a court order formally ending RPM is made, it is expected that no manufacturer will continue to enforce RPM from today.

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Decision soon on NHS 24 (May 14)

Scottish Health Ministers will soon be deciding how NHS 24, the Scottish version of NHS Direct, will be implemented.

A spokeswoman for the Scottish Executive told The Journal on May 11 that a blueprint for NHS 24 had been drawn up by a design and implementation group at the National Health Service in Scotland. The group contained representatives of the health professions, including pharmacy, nursing and general practitioners, as well as ambulance services and patient groups. The blueprint would be presented to Ministers in the next one to two weeks for further discussion and decisions.

The main difference between NHS 24 and NHS Direct in its first phase will be greater integration of NHS 24 and out-of-hours GP co-operatives and ambulance services.

The blueprint also says that many other services will develop links with NHS 24 through agreed protocols. These services will be introduced in its second phase. They could include pharmacy, community nurses, dentists, social workers, mental health services and GP services within working hours. Internet access to NHS 24 is expected to be introduced at some point.

The NHS 24 service will be managed by a special health board, based in Glasgow. The location of the call centres is to be decided as part of the blueprint, but three main centres may be established. The service will operated in the same way as NHS Direct, with triage nurses using clinical decision support software to help them in giving advice to callers.

A spokeswoman for the Department of Health said that she was unable to discuss the progress of the pharmacy pilot for NHS Direct in England because this was a matter of ongoing policy and could not be discussed during a general election.

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Government gives way on Health and Social Care Bill (May 11)

The Government has allowed contentious clauses to be removed from the Health and Social Care Bill in order to ensure that it completes its passage through Parliament before dissolution later today (May 11).

In the face of pressure in the House of Lords, the Government decided not to oppose an amendment to remove from the Bill a proposed power to prohibit the sale and processing of anonymised patient prescribing data. This means that, for the time being, community pharmacies will continue to be able to abstract data from their patient medication records in such a way that patients cannot be identified and sell it to marketing companies.

In addition, the Government decided not to oppose an amendment that would prevent the abolition of Community Health Councils.

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Wholesale change for Welsh pharmacy development committee (May 10)

The 10-strong Welsh Committee for the Professional Development of Pharmacy has eight new members. Two existing members have been re-appointed. All the appointments are for three-year terms.

The new appointments are:

• Stephen Newbury, an independent community pharmacist based in Swansea
• Peter Jones, a Boots primary care pharmacist for south Wales
• Jamie Hayes, a prescribing adviser for Conwy and Denbighshire local health groups
• Cheryl Davies, chief pharmacist at Singleton Hospital
• Emma Keenan, a senior pharmacy technician for cancer services
• Sue Shepherd, service support manager for head and neck surgery at the Royal Gwent Hospital
• Dr Stephen Daniels, director for undergraduate studies, Welsh School of Pharmacy, Cardiff University
• Dr Sally Davies, consultant in medical genetics, Institute for Medical Genetics, University Hospital Wales

The re-appointments are:

• Robert McArtney, clinical pharmacy specialist for Wales
• Professor David Luscombe, head of the Welsh School of Pharmacy

The Welsh Committee for the Professional Development of Pharmacy advises the National Assembly for Wales on postgraduate education and training needs of pharmacists and their support staff in Wales. It is also responsible for the development of strategy for the continuing professional development of pharmacists and their support staff.

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EC bans GSK's PI scheme (May 9)

The European Commission has banned GlaxoSmithKline Plc from operating a dual pricing scheme for its products in Spain which was aimed at cutting the volume of parallel imports.

In 1998, Glaxo Wellcome Plc (now part of GlaxoSmithKline) notified the commission of its plan to charge Spanish wholesalers higher prices for stock which they expected to export to other European countries than for stock for use in Spain.

The commission ruled on May 8 that the scheme could not be justified on economic grounds and that it would restrict price competition for GSK's products. It ordered GSK to end dual pricing immediately.

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Better checks on locums needed, says CHI (May 8)

National Health Service trusts should carry out better checks on locums practitioners before they are employed, says the Commission for Health Improvement.

Its conclusions come after an investigation into the practices of four trusts which employed a locum histopathologist linked with high error rates, but are just as applicable to pharmacists.

"The lessons we have drawn from this report can be used for the employment of all clinical and medical staff," a CHI spokesman told The Journal. "We found that trusts did not carry out any real checks. We suggest basic checks on somebody's employment history and qualifications. It's a very simply message."

In particular, the CHI report says that there is inadequate checking of references, full interviews are not carried out and there is little performance monitoring.

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More pharmacists needed to implement the NHS plan (May 1)

There are not enough community pharmacists in Britain to implement the government's agenda for pharmacy, says the National Pharmaceutical Association.

At its April meeting, the NPA management board estimated that pharmacy-based repeat dispensing alone would generate a 20 per cent increase in workload. Although this could be delegated, pharmacists were still needed for supervision and management. Cognitive services, such as medicine management, smoking cessation and prescribing for minor ailments would further increase the demand.

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April 2001

New gluten-free prescribing plan (April 27)

New arrangements are to be made for repeat prescribing of gluten-free foods for people with coeliac disease.

Government proposals for reducing the burden of paperwork for general practitioners include removing the need for them to issue such repeat prescriptions by December. No indication of the nature of the new arrangements has been given.

The proposals also include advice to people to consider seeking health advice from pharmacists or from NHS Direct, rather than troubling a doctor.

Making a difference: reducing GP paperwork

Cabinet Office
30 Great Smith Street
London SW1P 3BQ
Tel 020 7276 2194
fax 010 7276 2577
e-mail psinfo@cabinet-office.x.gsi.gov.uk

More details at the Cabinet Office website

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Maggots and Viagra win Queen's Awards (April 26)

Sterile maggots for cleaning wounds and Viagra (sildenafil) have won innovation awards in the 2001 Queen's Awards for Enterprise announced on March 21.

Glaxo dismisses Relenza (April 26)

GlaxoSmithKline has dismissed its influenza treatment Relenza as a niche product after it made a disappointing contribution to the company's performance. The contribution of the company's antivirals portfolio to its overall results for the first quarter of 2001 was held down by Relenza's poor performance, it revealed on April 24.

GSK cannot blame this on the treatment meted out to Relenza by the National Institute for Clinical Excellence, which first recommended that it should not be used in Britain, and then changed its mind, because the product also performed poorly in the United States.

Overall, GSK said that its performance was in line with predictions made February to deliver earnings growth of around 13 per cent this year. Savings attributable to the merger of Glaxo Wellcome and Smithkline Beecham were also on target.

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First clinical practice guidelines from the NICE (April 25)

The National Institute for Clinical Excellence has issued its first two evidence-based clinical practice guidelines this week. They are guidelines on secondary prophylaxis measures for patients who have experienced a myocardial infarction, and on best clinical practice for avoiding pressure ulcers.

The guideline on myocardial infarction (MI) makes recommendations on the care of patients who have survived a heart attack, with the aim of decreasing subsequent early deaths. It identifies when specific drugs, such as statins, beta-blockers, angiotensin converting enzyme inhibitors, antiplatelet agents, calcium channel blockers and potassium channel activators, should be used. It also provides recommendations for cardiac rehabilitation and diet. Specific advice on the care of patients who have previously had an MI and have heart failure and for patients with diabetes is also given.

The full guidelines are available on the NICE website (www.nice.org.uk). A report on the guidelines will be published in The Journal on April 28.

Society to host NHS modernisation website for pharmacists (April 25)

The Royal Pharmaceutical Society is to host a website devoted to helping pharmacists meet the challenges of National Health Service modernisation. The Department of Health is providing funding of £15,000 for developing the site.

The website is expected to be launched by the end of May. It will offer a toolkit for pharmacists who wish to be involved in the modernisation process. It will include NHS policy information, related pharmacy resources and examples of good practice from all sectors of pharmacy. The first areas to be developed will be concerned with older people's care and access to medicines.

The financial support from the DoH is the result of a successful funding bid led by Beth Taylor, pharmacy manager, Community Health South London NHS Trust, who is a member of the National Modernisation Board for England and its task force on older people. The bid was supported by Professor Alison Blenkinsopp, professor of the practice of pharmacy, Department of Medicines Management, Keele University, who serves on the board's access task force, and Beverley Parkin, the Society's Director of Public Affairs, who is a member of the board's communications task force.

The website is being launched in collaboration with other pharmacy organisations, including the National Pharmaceutical Association, the Pharmaceutical Services Negotiating Committee, the Guild of Healthcare Pharmacists and the Company Chemists Association.

The Society says that anyone who would like to offer material for inclusion on the site or to discuss possible links to other sites should contact either Mrs Taylor (Beth.Taylor@chsitr.sthames.nhs.uk) or the website co-ordinator, Pamela Mason (Pamela@mason189.freeserve.co.uk).

In an interview earlier in the year (PJ, February 24, p255), Mrs Taylor told The Journal that many pharmacists found it hard to access the information they needed to respond to the NHS plan. The website would try to anticipate their needs.

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OTC growth matches inflation (April 24)

The latest statistics on the over-the-counter medicines and food supplements market in the United Kingdom show an overall growth in value of just 2.5 per cent for 2000 over 1999. This is in line with the overall rate of inflation.

The greatest growth was in the anti-allergy sector, with an increase of 7.6 per cent over the previous year. Sleeping aids came next at 6.2 per cent, followed by eye care at 5.9 per cent. Year on year figures on smoking cessation, given for the first time, show growth of 5.2 per cent. Sales of products to treat cough, colds and sore throat grew by just 0.7 per cent.

Sales of food supplements overall were hit by scares about very high doses of certain nutrients, such as vitamin C, and concerns over interactions with herbal medicines, resulting in sales being down by 1.5 per cent. However, this still remains the third largest market with a combined value of £305.3m. Pain relief comes top at £389.6m, with cough, colds and sore throat second at £340.8m.

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Asda campaigns against RPM again (April 23)

The Asda supermarket chain relaunched its public relations campaign against resale price maintenance this morning (April 23) with a claim that pharmaceutical companies have exploited the delayed court case to force prices up by three-and-a-half times inflation in six months.

Asda backs up its claim with a list of example price increase and says that more are planned for the future.

“Our latest research shows that that drug companies simply cannot be trusted to set prices in the best interests of shoppers,” said Asda's health and beauty director, Jeremy Cross.

Before the RPM case began last year, Asda made a series of price cuts on various branded medicines and was forced to return prices to RPM levels by threats of legal action by their manufacturers.

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Industry satisfied with South African settlement (April 20)

The pharmaceutical industry has declared itself satisfied with a commitment by the South African government to respect international patents and has withdrawn its legal challenge to legislation intended to push down the cost of anti-retroviral medicines.

The Pharmaceutical Manufacturers Association of South Africa withdrew its action following an undertaking by the SA government to respect the international Trade Related Intellectual Property Rights Agreement (TRIPS). The association was challenging a provision in legislation which would have allowed the government to order compulsory licences for patented medicines with no right of appeal. According to GlaxoSmithKline, the SA government has confirmed that the new law will be implemented in a manner that accords with TRIPS and that there will be consultation with the industry on regulations to implement the law.

In 1997 the SA government introduced the new licensing law because it could not afford to buy all the medicines it needed to treat the country's huge AIDS problem.

Patients treated with Orlaam should be switched to alternative therapy (April 20)

Doctors who are currently treating patients with levacetylmethadol (Orlaam) for opioid dependence have been advised to review their patients immediately and to switch them to an alternative treatment.

The advice comes from the European Agency for the Evaluation of Medicinal Products (EMEA) after a re-assessment of the risk/benefit ratio of levacetylmethadol. The re-assessment followed reports of life-threatening cardiac disorders (see PJ, January 6, p8).

The EMEA says that patients being treated with levacetylmethadol should not stop taking the drug suddenly without seeking medical advice and should contact their prescriber immediately.

The EMEA has recommended that the drug's marketing authorisation should be suspended and says that supplies of the drug are to be progressively withdrawn from pharmacies to allow patients to switch to alternative therapies.

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Pharmacists praised in safety report (April 18)

Pharmacists in hospitals and the community are praised in a new report from the Department of Health for introducing good practice to reduce medication errors. The report “Building a safer National Health Service for patients” says that a new National Patient Safety Agency is to be created.

The report says that systems need to be put in place to ensure that lessons learnt from adverse events in one locality are learnt across the NHS as a whole. The new agency will establish a standardised reporting system, initially on paper but later electronically, for adverse events and near misses. The report sets targets of reducing the number of serious errors in the use of prescribed drugs by 40 per cent by 2005 and to reduce to zero the number of patients dying or being paralysed by maladministered spinal injections by the end of 2001.

Copies of the report are available from the Department of Health's website.

PSNC announces new chief executive and chairman (April 18)

The Pharmaceutical Services Negotiating Committee has announced that its new chief executive is to be Sue Sharpe, currently director of professional standards at the Royal Pharmaceutical Society. The new non-executive chairman is to be Barry Andrews, who has announced his resignation as retail director of Alliance Unichem Plc.

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Call for differential pricing to help poor countries (April 12)

Varying the prices of medicines from one country to another is a feasible way of ensuring that poor countries can afford the medicines they need.

That is a conclusion from a three-day workshop held by the World Health Organization and the World Trade Organization before Easter. WHO director-general Dr Gro Harlem Brundtland said the meeting had been constructive and helpful.

“It is clear that the price of medicines does matter - especially for people in poor countries,” she said. “We heard from the experts that much lower prices can be achieved for the poorest countries. Equally important is strengthening health systems, and, for the poorest countries, securing additional international financing.”

Although participants approached the issues from different points of view, there was broad recognition that differential pricing could play an important role in ensuring access to existing medicines at affordable prices, particularly in the poorest countries, according to Adrian Otten, director of the WTO's intellectual property division. At the same time, the patent system would be allowed to continue to play its role in providing incentives for research and development. Differential pricing has already been achieved for commodities such as vaccines, contraceptives and condoms through a combination of high-volume purchasing, reliable and adequate financing, advocacy, corporate responsibility and market forces. The challenge now is to find ways to expand this to life-saving medicines. Workshop participants accept that there is no single formula to achieve this.

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Gehe expands in Milan (April 11)

Gehe AG, the parent company of Lloyds Pharmacy, has acquired 80 per cent of AFM Milan SpA, which manages 84 pharmacies and two dispensaries in Milan, Italy.

The Milan municipal pharmacy group was the largest to be privatised so far. Gehe said that it was pleased that its combination of offer price and business plan for the future of the pharmacies had been accepted. Gehe now manages 139 Italian pharmacies. It also has majority shareholdings in municipal pharmacy companies in Bologna and Cremora.

Alliance UniChem Plc, the owner of Moss Pharmacy and UniChem Ltd, has also made a recent acquisition in Milan. It has purchased the wholesaling interests of Catena Farmaceutica dell'Adda, a purchasing and distribution group for 77 pharmacies in the Milan area.

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Dentists to be paid for CPD (April 10)

Dentists working for the National Health Service are to receive quarterly payments for undertaking continuing professional development.

Dentists will receive payments to offset loss of earnings for 10 hours of verfiable CPD each year and for up to a further five hours of approved training. They will be able to claim for up to six hours of travelling time for attending courses. The payments will be at the hourly rate of £52, scaled down by the extent to which the dentist undertakes private work.

The General Dental Council recently launched a recertification scheme. Dentists will have to undertake 75 hours of verifiable CPD over a five-year period.

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Health and Social Care Awards applications wanted (April 9)

Little time remains for applications to the Department of Health for this year's Health and Social Care Awards.

In an e-mail message to the Royal Pharmaceutical Society, the Pharmaceutical Services Negotiating Committee, the College of Pharmacy Practice, the Guild of Healthcare Pharmacists and the National Pharmaceutical Association on April 6, the Department says that there have been no applications with a pharmacy theme and that the chief pharmaceutical officer (Dr Jim Smith) wants the awards to be promoted as widely within pharmacy as is thought fit. Pharmacists who wish to apply for an award, worth £10,000 to the winners and £2,000 to runners-up, have until April 20 to submit their applications.

The awards, open to workers and organisations across the public and voluntary sectors and independent social care providers in England, will be made in six categories. They are

1. individual lifetime achievement
2. innovation
3. improving the working lives of staff
4. modernisation
5. improving people's lives
6. partnership working

Two awards, one for health and one for social care, are available in each category except partnership (one award only) and improving people's lives. In this category there is one award for improving the lives of people with heart disease, one for cancer, one for adoption services (social award only), one for innovative direct payments schemes (social award only) and two awards each (one health, one social) for work in mental health, older people, young people aged under 16-years, carers and disability work.

Applications will be judged by panels of experts from relevant areas against specified criteria and the Secretary of State for Health will present the awards in Manchester on July 5.

Details of the awards, how to apply and the judging criteria can be found here.

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Relaunch of the Industrial Pharmacist (April 5)

The Industrial Pharmacist — one of the casualties of the Royal Pharmaceutical Society's budget-trimming exercise for 2001 — has been relaunched with backing from major pharmaceutical companies. The four companies supporting the publication are AstraZeneca, Bristol-Myers Squibb, Pfizer and Reckitt Benckiser.

The relaunch follows a decision by the Society's Council at its February meeting to allow publication to continue during 2001 provided that commercial sponsorship could be obtained to cover its total editorial and production costs. A proposal that sponsorship should be sought from three or four multinational companies had been put to the Council by the Industrial Pharmacists Group Committee, which had earlier rejected a scheme that would have allowed publication to continue in electronic form only.

In anticipation of sponsorship being obtained, the editor, Joe Ridge, has continued working on future issues of the Industrial Pharmacist, and publication of the first is expected shortly. The newsletter is now being published by Mr Ridge's company through a third-party contract.

The group's chairman, Mel Smith, told The Journal that the continuing publication of the Industrial Pharmacist was due to hard work and negotiation by members of the group committee. He said that the committee had been inspired by all the support it had received from people who appreciate the publication.

The Society's Veterinary Pharmacists Group Committee is also investigating the possibility of obtaining sponsorship to support its newsletter, which was another victim of the budget cuts. Whether or not sponsorship is forthcoming, the Society hopes to be in a position to issue at least one brief newsletter for veterinary pharmacists during the year.

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Pharmacy Assistant of the Year 2001: new competition for all assistants (April 2)

The Pharmacy Assistant magazine and the National Pharmaceutical Association are running a great competition again this year — Assistant of the Year 2001 — for all pharmacy assistants. Details of this year's competition can be found in a special issue of The Pharmacy Assistant that was sent to all retail pharmacy premises at the beginning of April. Assistants who did not receive a copy of the issue can obtain one by sending a stamped (19p), self-addressed envelope to

The Pharmacy Assistant
1 Lambeth high Street
London SE1 7JN

Part One of the competition can also be found as a PDF file here. Print off a copy and pass it on!

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March 2001

Napp fined £3m for abuse of its position in morphine market (March 30)

Napp Pharmaceuticals has been fined £3.21m for abuse of a dominant market position in its pricing policy for MST Continus.

The fine is the first financial penalty to be exacted by the Office of Fair Trading under the Competition Act 1998. The OFT found that Napp had supplied its sustained release morphine products for use in the community at excessively high prices while supplying hospitals at discount levels that blocked competitors, giving it 90 per cent of the hospital market.

The company is to be ordered to cut the price of MST to the community and limit the degree to which that price can exceed hospital prices. Its hospital prices have typically been less than a 10th of its community prices. The OFT says that the price cut could bring immediate annual savings to the National Health Service of £2m.

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Pilots announced for ETP (March 29)

Three consortia are to undertake pilot schemes for the electronic transfer of prescriptions, the Department of Health announced on March 29.

The consortia are:

• Transcript (Gehe UK Plc, Unichem Ltd, Phoenix Medical Supplies Ltd and British Telecommunications Plc)
• Pharmacy2u (Pharmacy2u, North West Co-operative, Health Global Worldwide, RSA Security, Hadley Healthcare)
• Sema (Sema, Boots the Chemists Ltd, National Co-operative Chemists, Cable & Wireless, Microsoft)

The pilots will start later this year and run for at least six months. An independent evaluation of the pilots will test the benefits, risks and costs of electronic transfer and develop a business case for a national roll out.

Plain English guide (March 29)

The Plain English Campaign has published a free guide to writing medical information in plain English. It contains a glossary to help staff explain medical terms in everyday language. The guide is available from the PEC's website (www.plainenglish.co.uk/freepub).

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Industry and Government say: “It's good to talk” (March 28)

The pharmaceutical industry and the Government have published the final report of the Pharmaceutical Industry Competitiveness Task Force saying that they are pleased with the results of a year of talks between Ministers and senior industry executives. One of the main results of the task force is an agreement to continue to hold annual talks through a Ministerial Industry Strategy Group.

The task force was split into six working groups which looked at changes in the United Kingdom, European and wider pharmaceutical markets and responses which could be made to these. The industry had expressed concerns about the work of the National Institute for Clinical Excellence and will be involved in the first review of the NICE's work in July.

One area the task force looked at was the availability and prescribing of medicines which were not being reimbursed by the National Health Service. The report says that the mechanism for reclassifying such medicines from prescription-only to pharmacy-only status could be streamlined, and that there is scope for extending the use of patient group directions and giving prescribing rights to pharmacists.

The report can be accessed on the Department of Health's website.

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Solutions website for supply problems (March 27)

The pharmacy department at University College London Hospitals NHS Trust has put its Solutions newsletter dealing with pharmaceutical supply problems on the internet (www.uclhsolutions.com).

The pharmacy has been producing a newsletter dealing with shortages, supply problems and alternative medicines or supply sources for around six years. It was initially circulated to hospitals within the trust but, with support from IDIS World Medicines, it is now distributed to other hospitals. The website will carry updated information on current supply problems, together with lists of recent product withdrawals and discontinuations. The newsletter will continue to be distributed by e-mail and as a printed version on request.

The pharmacy department hopes that it will be able to analyse the reports on the website to give some insights into the main causes of supply problems. Access to the website will be free for hospital, community and primary care pharmacists. Pharmaceutical suppliers will be able to gain access for a small fee. Pharmacists can register through the website.

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Council member sets up expenses website (March 26)

Sultan Dajani, a member of the Royal Pharmaceutical Society's Council, has set up a website listing the expenses and allowances he received last year as a result of his Council activities. Mr Dajani received £28,637.31, comprising £12,398 in attendance allowances and £16,239.31 in reimbursed expenses.

Mr Dajani told The Journal that he had established the site in order to open up the Council's expenses system so that pharmacists could feel some ownership of it. He hoped that other members of Council would follow suit. He intended to list his expenses again for this year unless the Council introduced a policy which would prevent him from doing so.

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Unichem moves into Norway (March 21)

Alliance Unichem Plc has secured the rights to buy 53 Norwegian pharmacies following the relaxation of ownership rules there this month. It also has licenses for seven new pharmacies. The company operates 16 pharmacies in the Netherlands, eight in Italy and 30 in Switzerland as well as 712 Moss pharmacies in the United Kingdom.

On March 21, Alliance Unichem reported pre-tax profits of £133.7m for the year to December 31, 2000, up 9 per cent, on a turnover of £6.2bn, up 2 per cent.

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Clopidogrel reduces cardiovascular incidents by one-fifth (March 20)

Adding clopidogrel (Plavix) to standard treatment for acute coronary syndromes reduces the risk of serious cardiovascular incidents, including death, by a fifth, the results of a new study have shown.

The CURE (clopidogrel in unstable angina to prevent recurrent ischaemic events) trial involved 12,562 patients with acute coronary syndromes who were randomised to receive either clopidogrel or placebo. The overall primary outcome was reduction in the incidence of cardiovascular death, myocardial infarction (MI) and stroke.

Dr Salim Yusuf (Hamilton general hospital, Ontario, Canada), who presented the results of the trial at the conference on March 19, said that the overall relative risk for patients taking clopidogrel was 0.81 compared with those taking placebo. The figures for death, MI and stroke were 0.92, 0.77 and 0.85, respectively, he said. The finding that clopidogrel provides added benefits over standard treatment “is one of the most significant advances for patients with acute coronary syndromes since aspirin,” he said.

Patients recruited into the trial were randomised to receive either standard treatment alone (such as beta-blockers, low-molecular weight heparin or angiotensin converting enzyme inhibitors) or standard treatment plus clopidogrel. The patients receiving clopidogrel were given a loading dose of 300mg, followed by 75mg daily for between three months and one year. The trial investigators recommend that patients in both groups receive aspirin.

Dr Yusuf said that when survival curves were plotted for the two patient groups, divergence (indicating clopidogrel's benefit) was seen within the first 30 days. The most common adverse effect experienced by patients taking clopidogrel was bleeding (overall relative risk = 1.34). The investigators subdivided the types of bleed into life-threatening, other major, and minor. For each type, the risk was higher in the clopidogrel group. Dr Yusuf said that the increased risk of major bleeds was “small but significant” but there was no significant increase in life-threatening bleeds. He added that most of the life-threatening bleeds had occurred early in treatment and had been “easily reversed” by transfusion.

“Treating 1,000 patients for nine months prevents 28 major [cardiovascular] events in 23 patients and causes three life-threatening bleeds. This equates to preventing 50,000 to 100,000 heart attacks, strokes or deaths every year in North America,” he said.

Clopidogrel is an antiplatelet drug licensed for the prevention of atherosclerotic events in patients with a history of symptomatic atherosclerotic disease.

AAH plans £1m call centre (March 20)

AAH Pharmaceuticals Ltd is to spend £1m establishing a call centre to handle inquiries from its community pharmacy customers.

Starting this month, calls to AAH's depot at Ruislip, west London, will be directed to a call centre at Warrington, Cheshire on a local call rate number (0845 607 8899). Calls from Southampton will be rerouted in April.

Ms Trudie Newman (call centre project manager, AAH) said that around 80 per cent of the calls to AAH's depots were general customer account inquiries or orders. These calls would be directed to the call centre. The remaining 20 per cent or more complex queries would be dealt with on a one-to-one basis at branch level. Branches would continue to deal with hospital calls separately.

Once the pilot project has been completed, AAH intends to have around 100 staff at three sites in Warrington, Leeds and Glasgow. The sites will be linked to operate as one single call centre. AAH says that the new service will offer customers reduced call charges and a continually improving service level.

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Prescription charge to rise to £6.10 (March 16)

The National Health Service prescription charge is to rise 10p to £6.10 per item in England and Scotland on April 1. Welsh prescription charges have been frozen. Announcing the increase on March 16, Lord Hunt of Kings Heath (Parliamentary Under-Secretary of State for Health) said: “For the third year running we have held the increase to 10p in cash and at 1.67 per cent it is the lowest rate of increase for over 20 years. The Government is fully meeting its commitment to restrict the increase in prescription charges to no more than the rate of inflation.” Prescription charges are expected to raise some £414m for the NHS in England in 2001-02.

The same increase was announced for Scotland by Ms Susan Deacon (Minister for Health and Community Care).

The cost of prescription prepayment certificates will increase from £31.40 to £31.90 for four months and from £86.20 to £87.60 for 12 months.

Charges for elastic stockings and tights, and for wigs and fabric supports supplied through hospitals will be increased similarly.

A freeze on prescription charges in Wales was announced by the Welsh Finance Minister (Mrs Edwina Hart) on October 19, 2000. She also said that everyone in Wales under 25 years of age would be exempt from prescription charges from April 1, 2001.

At the time, Mrs Colleen Forse (secretary, Welsh Central Pharmaceutical Committee) said that the scheme was expected to be based on the location of the pharmacy at which prescriptions were dispensed, not the place of residence of the patient. This meant that English students studying in Wales would get free prescriptions while Welsh students studying in England would not.

Risk of cardiovascular events with sildenafil is not increased (March 16)

There is no evidence of a higher incidence of fatal myocardial infarction or ischaemic heart disease among men taking sildenafil (Viagra), prescription event monitoring has shown.

Dr Saad Shakir (director, drug safety research unit, Southampton) and colleagues sent questionnaires to general practitioners in England five months after they had first prescribed sildenafil. Information about cardiovascular events was obtained from 5,601 questionnaires. In patients who were taking sildenafil, there were nine cases of angina, 19 cases of chest pain, five cases of ischaemic heart disease and seven cases of non-fatal myo-cardial infarction. There were 10 cardiovascular fatalities associated with treatment. The standardised mortality ratio indicated no evidence for a higher incidence of fatal myocardial infarction or ischaemic heart disease among patients taking sildenafil, the researchers say. They conclude that although the results are reassuring it is inappropriate to accept these comparisons as definite evidence of equivalence between sildenafil users and the general population (British Medical Journal 2001;322:651).

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New product for preventing traveller's thrombosis (March 15)

Stockings to prevent traveller's thrombosis are being launched by Scholl. People at risk of developing deep vein thrombosis were advised to consider using compression hosiery by a House of Lords report at the end of last year. However, it gave no advice on the type of stocking to use. In January, Mr Stephen Barker (consultant vascular surgeon, Middlesex hospital, University College London hospitals NHS trust) told The Journal that a below-the-knee fitting was adequate for preventing flight-related DVT. He added that class I compression was sufficient for this purpose and that the degree of compression offered by class II stockings was unnecessary (PJ, January 27, p116).

The Scholl stockings, known as “flight socks”, will be available next week. They provide slightly less than class I compression and are a below-the-knee fitting. The stockings come in three sizes (shoe size 3-6, 6-9 and 9-12) and have a retail price of £11.95.

Scholl says that its flight socks will be marketed through “all good pharmacies” including Boots, and Scholl footcare centres. In particular, the socks will be available at branches of Boots based in airports.

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NRT products to be available as POM and GSL (March 14)

Nicotine replacement therapy products are to be prescribable on the National Health Service again, the Government announced on March 14 (No Smoking Day). All the products, with the exception of Nicobrevin, listed in Schedule 10 of the NHS (General Medical Services) Regulations 1992 and the NHS (General Medical Services) (Scotland) Regulations 1995 are to be removed from the blacklist by the end of April. At the same time, low-strength nicotine patches, lozenges and gum are to be made available on general sale.

The Department of Health is also proposing to allow nurse prescribers to prescribe NRT as a way of reducing the workload of general medical practitioners.

Serious liver reactions with leflunomide (March 14)

A statement regarding serious liver injury associated with leflunomide (Arava) has been issued this week by the European Agency for the Evaluation of Medicinal Products (EMEA).

The EMEA says that it has been made aware of reports of serious liver injuries, including hepatitis, hepatic failure and very rare cases of acute hepatic necrosis, in patients treated with leflunomide. A total of 296 cases of hepatic reactions have been reported to the EMEA, of which 129 were considered serious, and there were nine fatal outcomes. Most of the cases occurred within six months of initiation of treatment. The EMEA says that although confounding factors were present in many cases, a causal relationship with leflumonide cannot be excluded. Confounding factors included previous history of alcohol abuse, liver function disturbance, acute heart failure, severe pulmonary disease and pancreatic cancer. In 78 per cent of the serious reports, concomitant hepatotoxic medicines were being taken. The EMEA says that concomitant treatment with methotrexate or other hepatotoxic medication is associated with an increased risk of serious hepatic reactions and is not advisable.

In addition, the EMEA emphasises the need for strict adherence to monitoring recommendations. Preliminary data suggest that monitoring of liver function tests and wash-out procedures might not have been fully adhered to in some of the reported cases of hepatic reactions.

As a result of the EMEA findings, the prescribing and patient information has been modified. The information for patients includes the following paragraph: “Tell your doctor without any delay if you develop symptoms such as unusual tiredness, abdominal pain, or jaundice (yellow discolouration of the eyes or skin). Such symptoms may indicate the development of liver disorders which may need special action by your doctor.” The summary of product characteristics includes new information on monitoring of liver enzymes and administration of the drug following recent or concurrent treatment with other disease modifying antirheumatic drugs.

The EMEA statement is available on its website (www.eudra.org/emea.html).

New rural dispensing settlement agreed (March 14)

Regulations to implement a new agreement between pharmacists and doctors over dispensing in rural areas and market towns are to be drafted by the Department of Health.

Lord Hunt (Parliamentary Under-Secretary of State for Health) announced at the Pharmaceutical Services Negotiating Committee's annual dinner on March 12 that he had asked the Department’s lawyers to draw up new rules to govern applications for dispensing rights in rural areas.

These would be based on an agreement reached between the PSNC, the General Practitioners Committee and the Dispensing Doctors Association after three years of negotiations.

The joint proposals would benefit both pharmacists and GPs, the Minister said. They would also benefit patients because there would be less disturbance in dispensing arrangements and better relationships between pharmacists and doctors. The new regulations will prevent the establishment of dispensaries in surgeries in areas that are already well served by nearby pharmacies and will discourage new pharmacies in small rural communities where viability is questionable.

They will also ensure that no applications to dispense in rural areas are granted unless health authorities are satisfied that to do so will not prejudice the proper provision of either medical or pharmaceutical services to any community. This will include new partnerships formed by the amalgamation of dispensing and non-dispensing practices and the opening of additional pharmacy premises in rural areas.

The PSNC chairman (Mr Wally Dove) said that the agreement removed the threat of doctor dispensing in market towns and the vast majority of rural situations and provided stability in rural dispensing.

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PSNC heads for conflict over the pharmacy plan (March 12)

The chairman of the Pharmaceutical Services Negotiating Committee (Mr Wally Dove) has indicated that the committee is prepared to risk conflict with the Government over its implementation of the pharmacy plan.

Speaking at the 2001 local pharmaceutical committee representatives' conference in London on March 12, Mr Dove indicated that the PSNC would not accept any proposals to improve pharmaceutical services or to introduce new ones at the expense of existing provision.

The Department of Health had said in "Pharmacy in the future" that it wished to introduce a new national pharmacy contract which would change the terms of service and distribution of the global sum to establish minimum standards and to promote and reward high quality services and not prescription volume.

Making it clear that the PSNC was not prepared to see dispensing fees cut in order to reward new services, Mr Dove said: "We will not agree to something that further devalues dispensing or that is likely to lead to community pharmacies closing and services becoming less accessible."

However, he said that the PSNC was prepared to work with the Department to refine and agree ideas that were fair and reasonable and which properly rewarded contractors for providing a growing range of services.

Nurses to press for action on illegible prescriptions (March 12)

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting is to press the medical profession to include a specific reference to the legibility of prescriptions in its practice guidance.

To support its action, the UKCC wishes to hear from health professionals who have had difficulties with hard-to-read prescriptions. Submissions can be e-mailed to communications@ukcc.org.uk.

The issue of illegible prescriptions was raised at a UKCC meeting on March 7, when it was noted that the General Medical Council was consulting on a revised version of its "Good medical practice" document. Council members expressed concerns that unreadable prescriptions placed nurses who administered medicines in a difficult position. Doctors who did not provide clearly written prescriptions were not respecting the needs of other care professionals. They should be told to print prescriptions clearly and not write them in illegible cursive script.

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NHS hospital pay rises agreed (March 9)

Pay rises for National Health Service hospital pharmacists for 2000-01 and 2001-02 have been agreed.

For 2000-01 salaries and London allowances are to rise by 3.25 per cent, with a 3.7 per cent increase from April 1, 2001. Negotiations are continuing regarding emergency duty allowances for 2000-01, but a 3.7 per cent increase for 2001-02 has been approved.

The Guild of Healthcare Pharmacists said on March 9 that the increases represented a significant improvement on the original offer, which had been rejected (PJ, November 18, 2000, p744 and December 9, p844). In addition, health service employers have been reminded by the National Health Service Executive that they can pay supplements of up to 20 per cent (30 per cent in the four former Thames regions) when proven recruitment and retention difficulties can be solved by paying higher salaries.

New tax breaks for pharmaceutical research (March 9)

New pharmaceutical industry tax breaks announced by the Chancellor of the Exchequer (Mr Gordon Brown) have been welcomed by the Association of the British Pharmaceutical Industry.

In his budget speech on March 7, the Chancellor said that companies investing in research to develop treatments for malaria, tuberculosis and strains of HIV and AIDS prevalent in the developing world will be eligible for an additional 50 per cent tax relief on qualifying expenditure, in addition to existing reliefs for research and development expenditure. In addition, there will be a new vaccines tax credit to stimulate research into suitable vaccines. He further announced that company donations of medicines and equipment to designated international aid authorities and public health authorities will become fully tax deductible, along with the cost of transport and distribution of such donations.

Mr Brown said that the new allowances would help British companies contribute to the relief of diseases across the world which 8m people, including 3m children, every year in the poorest countries.

“We have a capacity to help and a moral duty to act,” the Chancellor said. He indicated that the tax credit would be extended if companies committed themselves to producing new medicines and vaccines in a way which met the needs of the poor and the sick.

After the announcement, Dr Trevor Jones (director-general, ABPI) said: “This is just the type of support that will reward entrepreneurial, innovative R&D in the filed of medicines research. We are particularly anxious that the biomedical industry should benefit from Government encouragement, as many of these are small start-up companies that are research intensive but are not earning revenue.”

NICE approves anti obesity drug (March 9)

Obese patients should be prescribed orlistat (Xenical) as one part of their weight loss plan, says the National Institute for Clinical Excellence (NICE). In guidance issued today, the NICE advised the national health service that orlistat should be made available to patients who were either:

• over weight (body mass index of 28kg/m² or more) if they have another serious illness, such as type 2 diabetes, high blood pressure and/or high cholesterol, which persists despite standard treatment
  
  
• or obese (body mass index of 30kg/m² or more) with no associated illness

The NICE says that therapy should only continue for more than three months if the patient has lost at least 5 per cent of their body weight from the start of drug treatment and for more than six months if weight loss has been at least 10 per cent of body weight. It adds that treatment should not usually continue beyond 12 months, and never beyond 24 months.

Full guidance is available from the NICE website.

NICE endorses pioglitazone use (March 9)

Patients with type 2 diabetes should be offered pioglitazone combination therapy as an alternative to insulin, according to guidance issued today by the National Institute for Clinical Excellence (NICE).

The guidance states that pioglitazone is effective at reducing blood glucose when added to oral monotherapy of either metformin or sulphonylurea for patients who have inadequate control of blood glucose on these agents alone. The NICE says that patients should be offered pioglitazone on National Health Service prescription if they are unable to take metformin and sulphonylurea as a combination therapy or if their blood glucose levels remain high despite adequate trial of this combination.

Guidance on the use of rosiglitazone was published in August, 2000 (see PJ, August 26, 2000, p288). The new guidance states that when a glitazone is prescribed, either pioglitazone or rosiglitazone may be considered.

The full guidance is available on the NICE website (www.nice.org.uk).

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Online OTC deals site in trials (March 6)

Starpharms.com, a website which will allow independent community pharmacies to access a range of manufacturers' special offers on non-prescription medicines, is about to enter trials. If successful, the site could be launched by the end of the month.

Mr Chris Wagstaff (marketing director, Starpharms) told The Journal that the site (www.starpharms.com) would allow manufacturers to include information, prices and special offers on their products. Once registered, pharmacists could look through the offers and place orders directly. These orders would be transferred to wholesalers for delivery in the normal way. The website allowed manufacturers to update their information at any time. Pharmacists would be able to keep records of the orders they had placed, make regular orders using previously saved data and track orders through the system.

A pilot trial in 35 pharmacies was about to start, Mr Wagstaff said. If successful, the site would be launched at the end of March or the beginning of April. Pharmacists would be able to get access to the site through IMS Health's Intrapharm service or through a dedicated internet device.

Asked how the new service would avoid the fate of many other business-to-business e-commerce sites, Mr Wagstaff said that the company had been working closely with manufacturers. A number of major manufacturers were expected to join the system. The company had been working to ensure that their information was presented in a format which was easy to use and quick to download. Money had been raised from a number of directors, including the company's chairman, Mr Kirit Patel. So far, it had not spent much money on marketing or advertising the service.

Once-a-week fluoxetine approved in US (March 6)

A once-weekly formulation of the selective serotonin re-uptake inhibitor fluoxetine (Prozac) has just been licensed in the United States.

The Food and Drug Administration has approved the product for treatment of the continuation phase of long-term depression (ie, patients whose depressive symptoms have stabilised, and who require continuing treatment to prevent a relapse or return of symptoms).

A spokeswoman for Lilly in the United Kingdom told The Journal on March 6 that Prozac Weekly contained 90mg of fluoxetine and was an enteric-coated, modified-release formulation that was taken once a week. An application for a licence for once-weekly fluoxetine had been made to the Medicines Control Agency and the company was awaiting their decision, she said.

New bibliographies from Society's Information Centre (March 6)

To complement its series of printed bibliographies, the Royal Pharmaceutical Society's Information Centre has developed a range of mini-bibliographies on topical subjects. Among the subjects covered are:

• supervised administration of methadone
• access to medicines out of hours (primary care)
• NHS walk-in centres
• ethical dilemmas
• "special" order products
• pharmacists' role in smoking cessation

Another new title, "Law and Ethics Bulletins", gives short summaries of all the Society's Law and Ethics Bulletin announcements published in The Pharmaceutical Journal since 1992.

The new series, produced using the centre's e-PIC database, is called "RPS e-PIC references". The titles are free to download as PDF files from the Technical Information Service pages of the Society's website (www.rpsgb.org.uk).

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Superdrug sale likely as former Railtrack chief takes over (March 2)

Superdrug Stores, the pharmacy, health and beauty chain of Kingfisher Plc, is likely to be sold off, the company said on March 1. The move follows a management shake up which sees the former chief executive of Railtrack Plc, Mr Gerald Corbett, being appointed executive chairman of Kingfisher's general merchandise division, which includes Superdrug and Woolworths. He has a brief to separate the division from the DIY and electrical retailing businesses.

In a statement Kingfisher said: "The decision on the appropriate method of separation, which now seems likely to include the sale of Superdrug, will be made in order to achieve the best value for shareholders."

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February 2001

Foot-and-mouth disease advice (February 28)

Pharmacists seeking further advice on foot-and-mouth disease can contact the National Pharmaceutical Association's information department on 01727 858687 ext 470 or the Ministry of Agriculture, Fisheries and Food's helpline on 0845 050 4141 (8am to 11pm).

The virus which causes foot-and-mouth disease can be destroyed by heat, low humidity and certain disinfectants. A list of disinfectants approved to control the spread of the disease and their dilution rates can be found on the MAFF website.

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Success for pharmacist-led diabetes clinic (February 27)

A pharmacist-led diabetes clinic has improved glycaemic control and reduced glycosylated haemoglobin (HbA_lc) levels in all attending patients with type 2 diabetes.

Dr Labib Tadros (clinical lead pharmacist, South Durham health care trust) told The Journal on February 27, that the clinic at Darlington Memorial hospital had been a success and that there were plans to expand it to other parts of the trust.

In a press release issued on February 21, Dr Tadros said that the clinic was set up to evaluate the impact of a clinical pharmacist providing direct patient care on the glycaemic control of patients with type 2 diabetes. A total of 50 patients with HbA_lc levels higher than 8 per cent who were already receiving oral hypoglycaemic drugs and who suffered hypertension with one or more secondary complications, were referred to the pharmacist. Patients visited the clinic every three weeks for blood pressure testing and a full urine analysis. Fasting plasma glucose levels and HbA_lc concentration were recorded every three months. The pharmacist's responsibilities include evaluation of current hypoglycaemic and adjunctive therapy, medication management and dosage adjustment, patient education, training on self-monitoring of blood glucose, and recognition and treatment of hyperglycaemia.

Since the clinic started in June, 2000, glycaemic control has improved and HbA_lc levels have been reduced by at least 50 per cent in all patients referred. In addition, all patients have become normotensive, thus potentially reducing the risk of developing long-term secondary complications of diabetes.

Dr Tadros said that, eventually, all patients with type 2 diabetes who were seen by the consultant endocrinologist would be referred to the clinic. He concluded: "Pharmacists working as members of multidisciplinary care teams can positively impact glycaemic control in patients with type 2 diabetes."

PSPG dissolved (February 27)

The Prescribing Support Pharmacists Group (PSPG), a group for pharmacists working in primary care organisations, has been officially dissolved by its members.

In a statement issued on February 26, the reason given was difficulties with time commitments and funding. Members are to have their fees returned. Any members who have not yet received theirs can contact Sue Knox at Rxadvice@aol.com.

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UK centres feature in GSK research reorganisation (February 23)

Two of Glaxosmithkline Plc's major research centres in the United Kingdom will become centres of excellence for drug discovery under plans unveiled by the company on February 22.

Speaking during a media briefing in London, Dr J-P Garnier (chief executive, GSK) said that the company needed to be both big and small in drug development at the same time. The company had to take advantage of its large size in the earliest stages of drug discovery (screening for potential new compounds) and the later stages (clinical trials and regulatory submissions). However, in the intermediate stages of development, where the potential of new compounds was tested, GSK wanted to capture the entrepreneurial spirit seen in smaller biotechnology companies.

To this end, GSK would be establishing six centres of excellence. These would be autonomous and able to compete for resources, and would make their own internal arrangements to suit the projects they were working on. In addition, the staff of the centres would be rewarded strictly on the basis of the work they produced. This would include share options and royalty payments from the sale of any successful medicines.

The six centres will cover

1. Neurology
   (based at the former Smithkline Beecham research centre at Harlow, Essex)
2. Respiratory
   (at Glaxo Wellcome's centre at Stevenage, Hertfordshire)
3. Psychiatry
   (Verona, Italy)
4. Antibacterials
   (Upper Providence, United States)
5. Urogenital, cardiovascular and oncology
   (Upper Merion, US)
6. Metabolic, bone and antiviral
   (Research Triangle Park, US)

Dr Garnier said that GSK currently had 161 projects in development, 117 of which were in phase I to III clinical trials. Of the 161 projects, around 50 were new chemical entities, the remainder were line-extensions of existing products or vaccines.

Over the past 12 months, GSK's two heritage companies (GW and SB) had licensed-in nine products from other companies. This, Dr Garnier said, showed that GSK was becoming the partner of choice for licensing-in new drugs.

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No new safety issues for amfebutamone (February 21)

There are no new safety concerns relating to amfebutamone (bupropion, Zyban), says the Medicines Control Agency, despite recent reports in the media. A spokeswoman for the MCA told The Journal on February 21 that the majority of suspected adverse drug reactions that had been reported were known to occur with amfebutamone and were listed in the drug's summary of product characteristics. There had been 18 reports of deaths suspected to be as a result of taking the drug. She added: "It should be noted that patients may be required to stop smoking because of underlying diseases and these may well explain some of the reported deaths in patients taking amfebutamone."

The most recent safety update statement for amfebutamone was issued by the MCA last year (see PJ, November 11, 2000, p712).

Second call for SGM over PJ editor post (February 21)

The Royal Pharmaceutical Society has received a second request for a special general meeting to be held to dis